SirToby, interesting.
There are plenty of third and fourth year students in Bristol very aware that they would not get a place if they applied now. And a sense that the current first year has a different profile. (The noticeable thing about DDs year is how few students there seem to be from London and the South East or from major private schools - almost in exact contrast to Bristol University itself.) Transparency means the chance for those in the know to focus their applications, making it more difficult for those who don't have the same level of resource.
Its a bit like London 11+. State schools are transparent - which leads to 11+ tutoring starting at seven, whereas independent schools have a bit more discretion. Most people would take grammar if offered, and independent have a level of selection by income, though there is still quite a lot of social overlap. Yet no obvious evidence from results that grammars, despite access to a wider pool, have successfully top sliced the most able, almost the reverse. A bit of discretion appears to help create a more level playing field.
Dyslexic DD who can't do timed tests was 800th on the waitlist for our nearest grammar, yet thrived in the private sector, was not interviewed at Nottingham despite good GCSEs because of a poor UKCAT but was able to use other strengths to gain a place at Bristol. It seems sad that this door is now closed to her and those of her friends with less standard profiles. I am not convinced, though I am sure others will argue, that UKCAT is a better predictor of who will make a good doctor than a strong PS which demonstrated a range of leadership, resilience, initiative, empathy and so on.
I hope a few medical schools remain open to those who don't fit easily into standard boxes. DD is really interested in other types of non-neurotypicality, including autism and her different, yet effective learning style (Bristol records lectures which is wonderful, as she can replay them rather than rely on note taking) will suit some NHS roles.
(And I hope it explains why it can be so difficult to read some of the "its so easy, DD just practiced with Medify a few times, and got four offers" type of posts. It was not easy for us. Nor for several lurkers who have messaged me in the past, or indeed for several kids we have known in real life. )