Views & Reviews Personal View

Selecting tomorrow’s doctors—not a level playing field

BMJ 2010; 341 doi: (Published 03 November 2010) Cite this as: BMJ 2010;341:c6108
  1. Lucy Stephenson, medical student,
  2. Terence Stephenson, former medical school dean, president of the Royal College of Paediatrics and Child Health, and a member of the GMC
  1. t.stephenson{at}

Figures from the UK Universities and Colleges Admissions Service (UCAS) show that, from 2002 to 2008, medical students were between 4.5 and 7.2 times (depending on the year) as likely to come from the wealthier socioeconomic groups 1 to 3 as from groups 4 to 7. (However, up to 25% of successful applicants don’t declare their social background on their UCAS form.) Selection to a medical course should not depend on the applicants’ financial status. However, with “grade inflation” at A level, choosing between applicants often involves other criteria that may depend on ability to pay. The selection process for many medical courses may favour applicants who undertake activities outside those paid for by the state education system, and some such activities are a mandatory requirement.

The hidden, upfront cost of a medical school application may include the following (2008-9 prices). Many medical schools require applicants to sit the UK Clinical Aptitude Test (UKCAT) or the Biomedical Admissions Test (BMAT) in addition to A level examinations. These cost £60 (€70; $96) and £32.10 respectively. Bursaries are available for poorer students to cover the cost of UKCAT. This year 2000 bursaries were distributed among 23 000 students who took the test …

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