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.

I'm far too dim to study medicine, but I went to a uni with a strong medicine department and that was not my experience (in the early 2000s) - of the students, anyhow. I couldn't say how many of the students qualified and then got jobs.

@KeepApart

Having done both medicine and dentistry, the selection process 100% favours middle class/upper middle class students

Applying for med school, with the knowledge of what the selection process was like, with friends in the field was so much easier than dental school. I knew what to say, what I needed to do. Yes I was much older but these are things that students with family in the field knew first time round. I had no clue when first applying because my school and family had no clue. Yes nowadays with Google it's much easier but you still need to start young, and have that background that values both education and extracurricular activities

I remember reading a couple of people's personal statements when applying for med school and it clicked as to why I only had 1 offer for dental school. I had excellent grades and I thought a decent personal statement but tbh it wasn't a patch on my privately educated friends.

The things you need take time, things like volunteering, most people will play sports and musical instruments for years which cost money. Many of my friends were coached and had tutors for their exams, went to courses on how to get into med/dental school. It was honestly like entering a new world when I first started

There's also lots of expensive exams and equipment you need throughout your early years as a student and as a new graduate. And I think a lot of the staff just don't really understand that the might not be costs some people can afford. I remember my personal tutor telling me to give up my part time job and get my parents to give me money as if this was something really simple.

That's not to say that no one from a lower socioeconomic status will ever get into med school, but it is easier if you are from a wealthier background, if you come from t right school and have family in the field.

The degree as well can be quite brutal, you need to be confident and well spoken, it favours that kind of public school attitude and often the tutors (rightly or wrongly) will favour a privately educated style persona.

Exactly. 100% agree with everything you’ve said

I think its always been thus, OP. I don't work in medicine, but another very competitive field, and despite being an over-achieving straight A student at A Level I really struggled to get into university- I've always suspected it was because I come from a really deprived part of the country. Even as a 17 year old I knew the odds would be against me so I volunteered in my chosen field (whilst also working in a part time job to help support myself), spent ages crafting my personal statement and prepared endlessly for my interview. Members of my family even got the money together to send me for a few elocution lessons to take the rough edges off of my accent before my interview. It made not a blind bit of difference, I got rejected two years straight and eventually managed to get in through clearing only because the particular university I ended up attending had made a mess of their admissions procedure for that year and they suddenly had lots of places in clearing to fill.

Upon starting my course I found it full of middle and upper class students with Bs & Cs at A Level who had got in on their first attempt. It was so damaging and dispiriting; ever since I've put huge effort into hiding my working class roots. I know I shouldn't have to, but it just seems to be the way of the world. Its so unfair because coming from a disadvantaged background you've already had to work so much harder to get to where you are.

@KeepApart
I remember reading a couple of people's personal statements when applying for med school and it clicked as to why I only had 1 offer for dental school. I had excellent grades and I thought a decent personal statement but tbh it wasn't a patch on my privately educated friends

I don’t know when you applied but things have changed massively since then. Medical schools are now very actively trying not to disadvantage any applicants. I’m not sure what expensive equipment you had to buy but my DC only had to buy an inexpensive stethoscope. I can’t think of anything else. 🤷🏻‍♀️ They also didn’t do any preparation courses (paid or free) for UCAT or for interviews. I think it would be tough to get through Medical Scool without any financial support but tbh if you were from a very low income family you would get the full student loan and maintenance grant. You might be better off than the squeezed middle class student where the parents are meant to contribute to the students maintenance but can’t afford it.

I think you are probably right tbh. I am from a long line of graduates in my family and I am having to work really really hard to fill in the gaps in the education system in order to get my son to a place where his academic ability will be properly used. It hurts my mind to think what it must be like for kids who don't have the good help behind them.

I can't see the point of this: there are many ways you can show us that you are a committed and caring individual, such as helping someone less fortunate or volunteering in a hospice nursery or elderly care home (quoted from Newcastle by DontBeCatty).

Caring, committed teenagers might be caring and committed in their everyday life but tend not to express that by taking on demanding care work while they're trying to study for A levels. You do that kind of thing pretty much only because it's going to help you get into med school, so all it demonstrates is your ability to jump through extra hoops. A budding psychopath who wanted to be a doctor would have absolutely no problem making sure they had evidence of their "caring, committed" nature. But a kid who has a home that's difficult to study in, needs to keep their Saturday job to help family finances, doesn't know anyone who would even dream of doing medicine, and goes to a school that's not geared up for preparing kids for med school admissions, might be a lovely kid who'll make a great, caring doctor but have no "evidence".

I think it's something that's easy to fake and difficult to assess, especially via a few forms and an interview. Much better to assess that later on, to the extent you can assess these things, when you have lots of evidence of them in person.

As a doctor from a working class background, no family member having been to university before, this post just annoys me. Full of guesswork and generalisations with no actual insight into the medical application process or the job itself...

I partly agree partly disagree. I got into medicine in the last 3 years from a poorly performing comprehensive school with no Drs in the family. But my parents were hugely supportive and willing to put effort in to help me wherever possible. It is possible to find good free work experience but it takes lots of research and getting it in a hospital is virtually impossible without knowing people.

The point someone made a few pages back about cost and medical school being expensive is a valid one too. The maximum student loan/grant students still requires parents topping up and filling in the rest. Which for students from poor families means they have to work part-time to support themselves. Meaning they don’t have the free time available for other CV building activities. (It’s possible that their grades may suffer too because of this but I have no data on that).

I'm not sure the admissions system actively discriminates. And it is correct there are some schemes where students from disadvantaged backgrounds are prioritised. (I'm not sure how helpful they are in reality though as the student still has to cope in an environment that is geared up for the privileged). But the system is stacked against people from disadvantaged backgrounds pretty much from birth, hence the label 'disadvantaged'. If we addressed these inequalities, then things like admissions to medical school would no doubt follow.

I would’ve loved to do medicine when I was a young thing, but didn’t have any way to get my foot in the door for the work experience. Parents didn’t know a thing about university applications either and I didn’t have the confidence and know-how to sit in an interview. Did a science instead and it has served me well, luckily!

@titchy

Could you give some actual evidence for your opinion?

I'm not the OP, but based on having read "This is going to hurt" , an autobiography where how to get into medical school in the UK is discussed, she has a point.

Having a doctor (or multiple doctors) among parents is highly correlated with becoming a doctor yourself.

High school grades are irrelevant, because there are vastly more applicants with perfect grades than there a places. This really hurts the chances of children from poor backgrounds, as doing better on grades could be their best option to distinguish themselves. (Even if the odds are loaded against them by being in a less good school etc.)

Because grades aren't enough to base a choice, admission look at other factors. The author (who I think had 3 doctor parents/grandparents) said he got in a result of having a grade 8 in saxophone and being the editor of pupil newspaper.

@titchy if anything it’s much easier these days as there’s plenty of resources online including YouTubers giving first hand experiences of applying for medicine, the student room with advice on personal statements/interviews and being able to research without relying on parental input.

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 he had (including giving injections) is relevant to medicine. He only got onto the medical course he did because one of the interviewers saw his potential and offered him a place. Incidently he is now a doctor and a professor at three of the local unis that rejected him. It makes me so furious.

Honestly threads like this are full of outdated anecdotes. They help perpetuate the myths that medical school applicants are only for the middle classes. I hope any non middle class parents reading this aren’t put off!
Clearly it helps if you have supportive parents and schools and clearly it’s better if you have additional financial support but the thought that you need to do lots of extra curricular activities and do loads of work experience Is outdated and wrong. As is the suggestion that you need to have well connected parents and do lots of expensive preparation courses.
Have a look at the CURRENT medical school entry requirements. They are very transparent and clear. Things have changed a lot since a lot of PPs went through the process of applying.

About 20 years ago I saw a TV programme about medical school admissions and interviews. It was clear then that applicants were very middle class. But what struck me most was the panel's decisons on personalities - they very obviously favoured conformity and doing well at school because parents wanted it. But anyone who had more independence of thought did not stand a chance of getting further than the interview. I hope this aspect of selection into medical training has changed for the better.

I agree. When I met a doctor with a strong West Country accent I was surprised even though in reality I shouldn’t have been. She had just as much right to be a doctor as all the other well spoken staff 🤷‍♀️ I guess it’s just what people are conditioned to accept, doesn’t make it right though.

@MsMoody

I would’ve loved to do medicine when I was a young thing, but didn’t have any way to get my foot in the door for the work experience. Parents didn’t know a thing about university applications either and I didn’t have the confidence and know-how to sit in an interview. Did a science instead and it has served me well, luckily!

Agree with that. DB did a medical related course and then transferred onto medicine at the same uni that rejected him when he initially applied. He now teaches there and at 2 of the other unis that rejected him.

My daughter is an F2 doctor and is from a comprehensive school background with no medics in the family. Don’t be put off applying by what people are saying on this thread. The admissions tutors can spot people only applying because of family pressure. She sat on admissions panels as a student so saw this process in action. There are so many valuable interests and volunteering opportunities that require no money and medical schools are looking for people with initiative and empathy and are unlikely to be impressed by someone just watching surgery for a couple of weeks. She worked as a volunteer for years at the riding for the disabled, did stuff at school and did a programme specifically designed to encourage state school pupils into medicine. It isn’t what you do so much as being able to demonstrate what you learnt.
What you do require as a student at a school with no or only a very few applicants to medicine is the initiative to find things out for yourself. The Student Room medicine forum was a great help with this and also deciding where to apply to maximise your chance of an interview. Aceing thé UKCAT helped as did a book about how to get into medicine with the kind if advice that private school kids would be given. To be honest, if you can’t deal with this kind of stuff independently, medical school will be difficult and being a doctor even harder.

In my opinion a lot of kids do medicine as mum and dad pushed them into it. Mine tried bit I rebelled. Applicants should be screened to see if there is a genuine desire and aptitude rather than a push towards something that might not be for them.

@RandomLondoner
Because grades aren't enough to base a choice, admission look at other factors. The author (who I think had 3 doctor parents/grandparents) said he got in a result of having a grade 8 in saxophone and being the editor of pupil newspaper.

Which Uni? Sounds extremely unlikely unless it happened years and years ago.

@SarahMused That’s what I’m talking about!

OP - as others have said your post could be written about any profession. DD wants to do medicine and is applying to be a volunteer with NHS cadets, but is highly unlikely to be accepted as they prioritise disadvantaged backgrounds. As we don't have medics in the family, it's going to be so hard to arrange work experience.

Personally, I find the medical application system seems to have a lot of unnecessary hurdles. In Ireland, entry to medical school is purely on the basis of grades. The 1000 applicants with the highest grades get the places and nobody cares about your hobbies. That seems massively fairer to me.

You are correct OP and the cycle of advantage / disadvantage starts at birth, not at high school. There are many complex factors at play and overwhelmingly med students are from privileged backgrounds. The comment about being able to google social capital is ignorant and facetious . I have been involved in teaching med students and I and most of my colleagues loved to see kids from the local area with local accents, who went to a local non selective high school in their lectures & tutorials. Always much easier to teach, genuinely more intelligent and hard working and with considerably better social skills than the usual posh cohort members.

OP and others - there is nothing much posted that reflects current practices. OP's link is 6 years old and uses stats even older.

Medicine is hugely competitive, as are some other degrees. That's the reality. Spending a week sitting in a GP reception may have been enough years ago, but hands on care experience is much more widely expected these days. Schools don't do enough and often don't have the right experience, or as posters here demonstrate, they think they know, but they don't (far more dangerous!).

NB students from low income backgrounds will get full maintenance loans for the entire degree so I'm not sure how that's a factor. Med students often do a bit of bank or care work. Cost won't be a factor.

Unfortunately some people are disadvantaged, and unis do their best to address that for all applicants to all subjects including medicine. But they can't do everything. Low aspirations amongst peers, family and teachers as well as shitty housing and poverty will all work against students. But for those that are bright enough and ambitious enough, unis will make allowances for any structural disadvantages individual applicants have.