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.

Evie the sport/music points is no longer a thing for university admission. Students are told now not to mention their grade 8 clarinet/gold DOE/rugby player of 10 years unless it is relevant to their course. This is especially true for highly competitive courses like medicine.

Interesting thread. FWIW I think it is more a case of 'cultural capital' than class. People who don't have the model of a certain profession within their family or friends are much less likely to choose that profession for themselves – not impossible, as proven by lots of the inspiring posts here from people who have become doctors without that model and despite tough circumstances, but less likely.

And conversely someone who has one, or even both, parents who are in a profession (be that doctors, lawyers, engineers etc) are more likely to see that as a desirable career. What is that phrase? – it's hard to be what you can't see.

I do wonder if people who have really had to struggle to get there but were determined to become doctors, by hook or by crook, might ultimately make better doctors than those who did it because a parent was… but it would be hard to evidence that, I think.

I've done research on this (I'm an academic). Haven't read the whole thread but it is true that medical schools are dominated by children of the affluent middle-classes. Some schools more than others. There is also stratification within the profession - people from more privileged backgrounds are more likely to be found in higher status jobs in the profession. Efforts at widening participation haven't been that successful. And the experience of medical school can be extremely alienating for people from non-professional or disadvantaged backgrounds. One of the striking things is there is massive nepotism which helps young medics develop research papers, etc, which help them get into the best Foundatinn Year training which helps them get into the 'best' jobs. It's a form of nepotism that would not be allowed in many other professions.

however the courses were looking for grades plus a varied and busy extracurricular life, e.g. sports teams, drama clubs, etc
This is absolutely not the case any longer. Very few even care about extra curriculum activities. What they care about is any exposure to a caring role and opportunities to show leadership quality potential.

You are utterly wrong OP. I manage admissions for a large well know RG med school. Our WP stats have increased during covid - in fact we're the highest amongst RG universities. We're proud of that and continue to work to strive for better representation. Myself, my team and the academic staff all feel very clearly about improving representation. Yes - it has happened but we are reversing these trends. You have a few 'facts' wrong - we don't actually take GCSEs into account. Medicine is always a bit of a lottery because of numbers but we have increased the diversity of admissions tutors, our visits to private schools must be held jointly with a state school and we have a number of initiatives to help those from less represented backgrounds. Stop hanging on to urban myths - if your offspring didn't get in then try again. Even well placed children of Deans etc have to sometimes try two or three times!!!

Also the best information that can help gaining knowledge to increase the chances of an offer are here on Mumsnet (further education) and tsr.

These two sites are easily accessible to anyone.

I agree that it's of course easier for someone to aim for and get accepted onto any demanding degree course if they've had the support early on, but fortunately there is lots of help for application forms and personal statements even if parents can't help with it. My dad was a doctor and while I didn't want to go to medical school, I did get lots of help with school from the start and he was helping me with homework and exam prep in a way he couldn't have done without having that academic aptitude himself. It was also assumed I would go to university and end up in a good career, and I was pushed to keep doing my best all through school. I also had a work placement through my dad's contacts (not in a medical setting).

I don't think it's fair to say this is why doctors are struggling with 12 hour days and difficult patients, though! Being a doctor is one of the few jobs where a lot of your decisions can literally be life and death decisions - of course even more so in some specialist areas like surgery. You can't compare the concentration, skill and responsibility to that of doing most other jobs where making a mistake is inconvenient but no one will die. Or for that matter the toll it takes on anyone's mental wellbeing to deal with that responsibility within a very busy service - GPs for example see a huge number of patients every day.

@sunnyandshare

Evie the sport/music points is no longer a thing for university admission. Students are told now not to mention their grade 8 clarinet/gold DOE/rugby player of 10 years unless it is relevant to their course. This is especially true for highly competitive courses like medicine.

That memo clearly hasn't got to any of the admissions tutors I have spoken to over the past year who all seemed to be interested in teaching interesting people. People who have grade 8 clarinet, gold DofE and are rugby players tend to be more interesting people, although there are no guarantees of this. I have never heard any university say do not put extra-curricular activities on your application form.

14 kids got into medicine in DD's year from her comp, most were low income due to the catchment. In areas like ours without grammar schools it's a lot more egalitarian

Exh lectures 2 year medics and I can assure you they are a cross section of society, but it's not a prestigious London med school or Russell group

@Eviebea

Interesting views. In my experience & I've known med school entrants from all walks of life, it's very much down to the individual applicant and their all round achievements & not simply academically. An applicant has to prove dedication to something other than grades eg sport, music etc and be at the top of their game in those pursuits. They definitely prefer applicants with loads of interests and hobbies.

I agree. But thats just another barrier for disadvantaged students given that hobbies and interests almost always come at a cost, and need to be facilitated by parents. It would be difficult to be a high achiever in music without a parent who could afford years of lessons and an instrument.

who all seemed to be interested in teaching interesting people.

They're really not. Do you somehow imagine med lecturers are interested in debating the merits of the Pastoral Symphony with 18 year olds in the break? Lol! Why would they care if someone is 'interesting'?

So much incorrect information on this thread. Good to see the posters who actually work in medical school admissions comfirm that they are doing everything they can not to disadvantage anyone.

The grammar school system was supposed to try and even out social background and academic education.

If all areas were grammar school areas then those who were most academic would get a highly academic education and those who do better with more vocational learning would benefit from that. Where they lived wouldn't come into it.

Now we've only got grammar schools in a small number of regions, all of which are fairly middle class because the middle class have the funds to choose to live there to benefit from the grammar school system.

My niece is a Dr. Her mum works in a supermarket and her dad drives a lorry. She went to the grammar school nearest her house. She worked really hard to earn her place at uni, but she was in the minority coming from that background.

Teenagers need to think carefully about medicine as a career
It’s particularly dangerous ( in a mental health sense) for empaths trying to do an impossible job safely for patients
The screening should focus on the psychological profiles of applicants to see if they can cope.

I agree it should be a postgraduate degree so people can change path without fear of failure

@jgw1, it used to be that you got points for extracurriculars but that is no longer the case. I'm sure those in admissions would like to read about DOE treks and grade 8 in the bassoon as it would break up the monotony but the current advice is not to focus on these things as the PS is awarded points on subject relevancy. Mentioning them in your hobbies/interests is fine, but they are ultimately not going to give you an 'edge'.

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).

When I applied for graduate medicine it was very much the opposite, you were encouraged to do care type work over, say, shadowing your dad's friend who was a surgeon. The work experience I had was working in a respite home.

I never took up my place, lucky escape I think :-)

@GrumpyTerrier - ours works in pretty much the same way. It is a problem because there are so many other barriers - imposter syndrome, finances etc - we've spent a lot of money on various schemes - all of which were codesigned by students but none have been a magic bullet. It doesn't help that many of these admissions myths still perpetuate!

@Flammkuchen

A big difference from 20 years ago are contextual grades and priority for work experience. Universities do massively more outreach than in my day.

Also workplaces are massively more concerned about the diversity of their staff. My last two workplaces have race and gender targets, though not yet social class. That is a shame as statiscally white working class boys are the group least likely to progress to higher education.

www.hrmagazine.co.uk/content/news/kpmg-sets-working-class-diversity-targets

@Lindy2

The grammar school system was supposed to try and even out social background and academic education.

If all areas were grammar school areas then those who were most academic would get a highly academic education and those who do better with more vocational learning would benefit from that. Where they lived wouldn't come into it.

Now we've only got grammar schools in a small number of regions, all of which are fairly middle class because the middle class have the funds to choose to live there to benefit from the grammar school system.

You're right, it was. The problem is that deciding on the right educational path for children at the age of 10 based on a particular type of (non-curriculum) test, taken on a single day, is a particularly crap system.

Educational achievement is not linear – some children peak early but never develop, others struggle initially but blossom later, and others achieve more as the number of subjects decreases and they can concentrate on what really interests them while other remain good all-rounders etc etc etc.

A form of education which allows pupils to move freely up (and down) different sets for different subjects and make the most of their talents at different ages is much better than a rigid 'academic education suits you, but not you' approach.

@Flammkuchen I don’t see how hard it would be to lie about your class though if you wanted to get ahead. It’s not like you can prove your parents’ professions especially if they’re dead or retired.

Also ‘race’ in large firms is a bit of a red herring as there are plenty of international students with expensive educations, as privileged as they come. They milk the ‘diversity’ card for all its worth but apart from their skin colour there’s nothing differentiating them from white MC people. In my experience racial diversity groups were just used as a vehicle to get ahead by these people so I stopped attending

Blimey. No evidence for this then. Just discontented grumblings.

@5keletor

I agree with you, OP. I used to be an academic researcher, broad focus on equity in education, one particular piece of research involving final year secondary students from schools in disadvantaged areas applying to study medicine. This included areas in one particular city, I should say, but none of the students I spoke with were accepted. All of them had the grades, however the courses were looking for grades plus a varied and busy extracurricular life, e.g. sports teams, drama clubs, etc. Cost was a big factor - most parents couldn't afford the fees and equipment/clothing needed to regularly play certain sports, and some kids were scared to even go swimming, for example, because the area was so rough they didn't feel safe in the changing areas. So they simply couldn't partake in the extra activities needed to boost their chances.

@5keletor

When was this research carried out? Massive difference between medical school admission now compared with a few years ago.