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.

@x2kids

I’m curious why you think that the fact your daughter is an ethnic minority would disadvantage her? Did you get that impression from this thread?

@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?

The posts that suggest that someone from your background stands no chance are utter nonsense. She stands just a good a chance as anyone else who applies with the same academic grades, skills and qualities. Universities work tremendously hard to ensure that is the case and for particular deprived groups have systems to support applications. A long list of work experience shadowing all your uncles who are doctors is not what medical schools are interested in. Some work experience if possible is helpful if the student can then talk interestedly about what they have seen and has done further research about it. More importantly is evidence of long term commitment to caring and supporting others. That could be looking after a younger sibling, volutneering at junior parkrun, brownies, cubs or any manner of youth or elderly groups.
Have a look at medical doorway - Ben is very helpful and knowledgeable, or pm me if you want further advice.

@X2Kids, you daughter being from an ethnic minority will in no way disadvantage her at medical school. As I mentioned somewhere on this thread, I used to work in a big medical school in London and it was even more racially/ethnically diverse than the general population of London, I would say. A lot of the clinical academics doing the teaching and running the programme were also not White British. This reflects the NHS in London, and I'm sure elsewhere too.

Good luck to her!

[quote awishes]@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.[/quote]
None of those costs are upfront. The repayments are exactly the same if you graduate from medicine with a £120k loan debt or media studies with a £20k loan debt.

Dentistry requires work experience in a gdp. NHS dentists would nt take my dd and after dropping off 20+ cvs a private practice finally did and were very accomodating. Those at grammar and private schools have the connections.

Can't disagree with the OP. Over many years of dealing with UCAS applications almost every student who got in to study medicine/ dentistry had parents or other close relatives already working in the field.

A lot of this is due to work experience - they had the contacts to be able to do this. It's very hard for under 18s to get this work experience.

@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?

Nah, at several of DD's medicine interviews, the bulk of the candidates were ethnic minorities. Absolutely not a barrier.

Also, there is a lot of chat about impressive work experience, which is definitely not required. Universities are aware of how hard it is to find hands-on medical experience. DD volunteered as a cleaner and kitchen worker at a care home. They were perfectly happy to chat to her about her observations from that perspective. It's not about the actual work, but about their take-home thinking.

@amillionmenonmars

Can't disagree with the OP. Over many years of dealing with UCAS applications almost every student who got in to study medicine/ dentistry had parents or other close relatives already working in the field.

A lot of this is due to work experience - they had the contacts to be able to do this. It's very hard for under 18s to get this work experience.

I work in a University that has a medical school. "The system" does overall favour those from better off backgrounds. It was not that long ago that the first question on our Uni's application form for medicine (after the applicant's demographic details) was "father's occupation" - those whose fathers were doctors were put to one side etc.

Universities now are required to show that they have a certain amount of students from deprived backgrounds (in Scotland, it is the Scottish Index of Multiple Deprivation post codes they use). These figures need to be published so they absolutely need to do this. The Scottish Government recently funded additional med school places in Scotland to catch those from deprived backgrounds who just failed to meet the academic entrance requirements - but they effectively need to do another year. All the stuff about having Duke of Edinburgh gold award, volunteering etc that goes on applications - all well and good to have wider skills but they won't help a student pass the extremely difficult medical exams. At the end of the day, medicine (and law, veterinary science, dentistry) are degrees for the very academically gifted - either though innate ability or through coaching and learning from birth. What I would say though is - some of the brightest/genius medical students I have worked with have very black and white thinking and really lack emotional intelligence and empathy, which doesn't make the best doctor.

Having dealt with academic appeals from students who have not met the criteria for progression on the medical programme (ie they have failed exams/assessments), the majority of those students in my experience are from deprived backgrounds - they are more likely to need to work to support themselves giving less time for study, and for example, if a library book is not available, they cannot afford to purchase it. They may also struggle to pay the costs associated with attending clinical placements which can be some distance from the University. There is also a mandatory overseas placement (outwith Covid) which can cost the student a lot to fund.

Places are extremely competitive - add into the mix that in Scotland, tuition fees are capped for home students. So the University will get around £9000 per year for a home medical student. They can charge what they like for international students who pay at least £40k a year. So international students are really attractive to Universities.

I think it just mirrors society generally - those who can afford more get more, and get it more easily. Sad but true.

My brother is a junior doctor. We come from a low income, working class family. Neither parents were educated beyond high school level. He is my parents 3rd child and we all went to uni and are healthcare professionals. Our colleges were poor performing but still able to help write personal statements and due to the gifted and talented scheme we were able to visit unis and talk to students there. He was encouraged and supported by school and my parents and it helped that he had a sister at Uni and myself who had graduated by the time he applied. In a family where you are the first to go to uni (like myself) you have to do a lot of research yourself and I was well motivated. It is harder than if you have family that have already been through the process but that is life and you can't always let that hold you back.

The hardest part was getting the required work experience as medical schools won't consider you without it, we researched and found out about hospital volunteer schemes and he applied and joined one (he was lucky to have this support as he didn't know where to start). It's a lot easier if mum or dad is a dr and can ask a friend if you can shadow them for a week. To get to the hospital meant he had to take two buses so that required money which he used his EMA for (not sure if kids get this now), he also got a part time job to help. My dad whilst drop whim where he could but due to dad's long working hours it wasn't always possible.

He had no guidance for the interviews other than what the unis he applied to sent out and he researched online. However we did work on how to stay calm in an interview and explaining and expanding points, linking back etc.

He loves his job and is great with patients and well liked by his peers and seniors. He did say that even at his uni a lot of the students came from more middle class backgrounds and went to fee paying private schools. That though doesn't necessarily make them great doctors but the privilege helps with networking even when they qualify.

He has a dear friend who was pressured into studying medicine by her doctor parents as she was clever and they thought it a natural progression. She aced exams but dropped out in the second year when things started to get more patient facing as she didn't enjoy working with the public. She worked in retail for a while till she went back to uni and got a degree in sciences. She now works in a lab and is doing brilliantly.

I think there is a lot more help and support for students from poorer backgrounds now from universities and colleges. Ultimately the greatest support comes from parents and the need for you to be motivated to help yourself.

Medical schools prefer to admit kids who have got some experience working in a medical setting but they don’t include care work (which is the only way a working class kid would be able to get experience). This is such a huge problem as these work experience opportunities are never advertised and It results in the relatives of doctors / nurses / paramedics getting the edge. My neighbour had 2 kids go into medical school - one got in based on 2 weeks of filing experience at her Uncle’s GP surgery. The other shadowed another uncle for a week at a hospital. Neither opportunity was advertised. In the meantime my brother who got close to 100% in each of his A Levels couldn’t even get an interview because he couldn’t demonstrate how the 10 years of care experience (including giving injections)

This is a load of rubbish. How do you know it was the week of filing that swung it for him? And the fact that you think giving injections should be an advantage demonstrates that you don't understand the process at all.

It's competitive to get into and doubtless those with family support are at an advantage. But the attitude that because your brother didn't get in, the process is unfair, is probably part of the problem. I got turned down twice for a competitive course. I researched and did what I could and got in 3rd time. I know plenty of others who did the same.

This has probably already been said but I don’t have time to read 11 pages. Lots of Med schools now have a 6 year course which accepts pupils from deprived areas with lower grades such a BBB. There is still lots of work to do but I do think med schools are trying to address the issue.

I think there is a lot more help and support for students from poorer backgrounds now from universities and colleges. Ultimately the greatest support comes from parents and the need for you to be motivated to help yourself.

Yes. It's often lack of aspiration, lack of confidence that holds people back. It's definitely harder for those from mediocre schools but it's not that hard either, especially nowadays with the internet.
Plenty of working class people have extremely supportive parents who value education.

It's not just lack of aspiration or access to work experience, you need also need high achievement and to jump through a lot of hoops. 3 As at A level, many med schools also look at GCSE results, you need to also take the UCAT and/or BMAT tests. Only very organised kids who have started planning at the beginning of year 12 latest are going to be able to tick all the boxes.

[quote DontBeCatty]@x2kids

I’m curious why you think that the fact your daughter is an ethnic minority would disadvantage her? Did you get that impression from this thread?[/quote]
@DontBeCatty no this thread hasn't suggested her ethnicity will impact her chances in medicine. But I'm aware that in other careers that BAME individuals I hate that term have to work much harder to get the recognition but I accept this may not be the case in medicine. I think it's the class issue that's alerted me to the fact she may struggle.

She isn't the first to go to uni in my family. And her uncle is a radiologist, her dad and aunt both work in hospitals although HCA/ domestic level, so I'm sure we can cobble together some work experience amongst us.

As someone else has said, I think supportive family is also imperative. She knows she has my full support and I'll do whatever I can if this is what she chooses to do.

@Stuckhere2021. Are you sure that the placement abroad is mandatory? I didn’t think it was.

If it is mandatory, surely there will be a hardship fund to help students who couldn't do that otherwise.

In a much earlier job, I had some contact with medical students doing an elective (which is what the overseas placement would be, I think). Electives are short periods built into a medical degree where the student sorts out their own placement, to get experience of something they wouldn't otherwise get during their undergraduate studies. A lot of students go abroad to see a different healthcare system and culture close up. The ones we dealt with, though, were looking to observe a niche medical sub-specialism. They came from all over the UK and some from abroad. They sorted out their own accommodation and funding, and we just put together a timetable for them with some academic/research elements to fill up the days when there wasn't so much going on clinically.

Medicine pays so badly in the UK, the conditions are so poor and you have to work such long hours I can't think why anyone would go into it unless they came from family wealth and had some altruistic desire to give back. All the Drs I know have significant family backing - massive help on property ladder, support when training to be consultants and having to move up and down the country to progress their careers. A day out with group of friends in our 30s and we all revealed what we earned and we were somewhat chastened that the consultant paediatrician who worked 60 hr weeks and often weekends was on the least, amongst a group of financial services, project managers and various other private sector workers.

Nope.
My son has had to complete so many forms in his quest to find out more about applications. He doesn't qualify for any of the inclusion criteria - he is male, white, goes to a grammar school, we are not on any benefits, our post code is ok and he is at least 5th generation or so of his family who have gone to university. This actually goes against him for applications (but obviously not for life in which he has privilege).

I'd rather see schools giving better exposure to different types of occupations which young people wouldn't be aware of. Everyone is aware of medicine but there was nothing at my school about financial services - which is almost 10% of the UK economy and has much better earning potential. Or entrepreneurism and setting up your own business rather than expecting jobs to be created for you.

I got into medical school back in 1994. Noone else in my family has been to university -my parents are disabled and did not attend mainstream school (as was common back then).

As far as I know, my application was treated favourably under a widening access scheme -so my postcode (socially deprived area) actually helped. My parents were also in receipt of benefits and that may have contributed to the positive discrimination I benefited from. These schemes are in place now and again to try to level things.

I've been right through the process -applied and interviewed back in the day when it was all down to a highly biased interview and then worked as an academic doctor for a number of years and was involved medical school entry in the newer OSCE based interview process.

I think despite attempts to avoid bias, it remains biased toward children from medical/professional families. This is partly because these parents have been consciously/unconsciously coaching their kids to perform well and look like "the right fit" their whole lives. It's also bias from those selecting students; there's a perception that the kids of doctors have a better understanding of what they are getting into (won't drop out). That was openly said to me at one of my interviews; they were keen to point out that they wouldn't wish to exclude me because of my family background, but that without any doctors (or professionals even) in the family, I may not properly understand the commitment I was making. (Hah! It's true. I didn't.) It's good that there are attempts to make the process more anonymous and keep the decision makers blind to these things now.

My advice would be:

Getting into medical school isn't just about the grades. The OSCE is a challenge for the book-smart kid who lacks confidence in communicating with others.

Any public facing experience will help performance at the OSCE which best suits young people who look calm(ish) and comfortable when talking with examiners. But if they can get a bit of volunteer experience in a medical setting that would be very helpful, as are things like Scouts and Guides leadership.

Kids from public schools get more preparation and are more confident in manner. Huge inequity here that just confirms what we all know -it's not a meritocracy out there, most of your life course is determined by the circumstances you are born into. If your child is at state school and doing well academically, you might need to think creatively about rounding this out to improve their chances. A student from public school should not be treated preferentially, but is still likely to be selected over a state school child by a blind examiner simply because of these differences in "performance". You can hear this difference in some of the typical OSCE stations -a question that prompts debate of competing issues...there are some candidates that respond with fixed black and white answers (they believe there is a right or wrong answer) while others seem more practised in debating and discussing the shades of grey, and even more so understand the question is a prompt for debate.

@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?

Don’t be put off by posts here OP. ‘Competitive’ means that medicine requires effort. You can’t start thinking about it 3 days before you submit your UCAS applications. You’re already doing this so that’s good. It’s a lot easier for any other profession to get a place (engineering, law, finance).

Of course plenty of other degrees are even more competitive (nobody’s getting into the performing arts ones with zero background) but that’s not the point.

Medicine has a lot of ethnic minorities anyway since it’s a profession. You won’t find many in politics or similar however … speaking for South and East Asian immigrants however Not sure who anyone else

I think the problem with this thread is that there are too many posters having their penny's worth who really don't have much idea about studying - or practicing - medicine. This is peppered with some useful posts from posters who do but this is getting lost in all the sweeping generalisations and ill-informed misconceptions. For anyone who is thinking of applying to study medicine, do not be put off. It is stressful competitive, difficult etc. but it is absolutely possible. Many people have to apply twice regardless of background. TSR is a great source of information of exactly what is required and there are professionals there that can help guide you through. Ignore the naysayers and good luck.

[quote DontBeCatty]@Stuckhere2021. Are you sure that the placement abroad is mandatory? I didn’t think it was.[/quote]
I'm pretty sure it is at our Medical School unless you have a specific reason for not going (eg you are a carer) as I'm sure I've heard it discussed in meetings - but I'm not in that school so I could be wrong.

Placements abroad are not necessary at all medical schools.

@Stuckhere2021. I’m not sure why you would post that it was mandatory to have a placement abroad if you arent sure if it’s true. 🤷🏻‍♀️
If it’s Edinburgh University then the online info says
In Year 6, you will have the opportunity to undertake a medical elective: a period of study at another medical school or clinical placement provider. This is usually taken abroad