Selecting tomorrow’s doctors—not a level playing field

While the article can seem rather disheartening to prospective
medical students from a poorer background, I would like to offer them some
suggestions. The Education Maintenance Allowance (EMA) offers financial
support between £10 and £30 per week to A-level (amongst other) students
of lower household income, which is very useful in covering the costs of
odd journeys to University open-days or vaccinations. The support is not
affected by a student's earning from a part-time job (1).

As for the admission tests, UKCAT and BMAT offer bursary and
reimbursement respectively, meaning students should never be financially
deterred to sit those exams. Regarding guidance from external agencies,
there are numerous expensive courses that offer interview coaching et
cetera. Equally, however, charities such as the Social Mobility Foundation
exist, offering mentorship to students who cannot afford the more luxury
options. Moreover, schools may offer similar support - I was fortunate to
be in a school where the alumni offered mock interviews to 6th formers.

In terms of work experience, while doctor shadowing pre-arranged by
professional parents is certainly impressive on the Personal Statement,
many other opportunities exist. Again, money should not be the deterrence
factor - I recall from my volunteering experience in British Red Cross and
University College Hospital, where both provided travel reimbursements.

Although a Grade 8 in the flute and piano will look notable on the
personal statement, universities also look at other extra-curricular
activities, such as being in the school choir or sports-team, which may be
equally or more essential than solo-activities. These activities
demonstrate vital skills such as teamwork and leadership, which are
important in selecting tomorrow's doctors.

With the eventual rise in Tuition Fee pushing future medical
graduates into even greater debt, I believe it is important to note that
while the various fees and costs mentioned may deter poorer students from
applying to Medicine, safeguards do exist. The only criterion for entry
into a medical school should be the competence to become a professional
doctor, rather than one's social status or family connections.

1. FAQs | Department for Employment and Learning. Available from:
http://www.delni.gov.uk/index/further-and-higher-education/ema-educational
-maintenance-allowance/ema-faqs.htm.

I think the authors raise many valid points. When searching for my
ideal medical school I attended the Medlink course in Nottingham before
travelling the length and breadth of the country from Aberdeen down to
Southampton until I settled on Newcastle.

Once at medical school I bought books, attended revision courses and
spent a fortune on an elective - none of which would have been possible
without parental financial support.

I agree with the authors that attending interviews, courses and open
days is a costly business but how can you stop savvy middle class parents
investing in their children's future?

Could the solution lye in a truly national recruitment process? A
single national selection exercise run at different regional sites across
the country with representation from all medical schools. This would
reduce the costs involved in travelling to multiple interviews and would
offer the opportunity of a more rigorous less biased selection process.

The cynics amongst us will point out this would just spurn another
industry of books and revision courses that only the same affluent would
be medics could afford and leave us back at square one!

The Stephensons' thoughtful arguments stimulated me to reflect. I
came from a relatively poor Indian immigrant family brought up in the
inner-city slums of the Gorbals of Glasgow in the 1950s and the leafier
suburb of Shawlands from 1964 onwards. My parents had four years of
primary schooling between them.

I was accepted to the University of Edinburgh's Medical School, from
state funded comprehensive education, solely on academic grounds. No
interview was required, and as far as I can tell, there was no evaluation
of Duke of Edinburgh awards, formal music lessons or anything of the like.
I was lucky, because my parents had never heard of such ideas and the
prospects of financial support for such alien expenditures was zero. By
contrast, my parents did instil a strong work ethic. My brother graduated
from Glasgow University in 1974, and I in 1978 from Edinburgh. I did not
have a penny in debt, took no money from my parents over the seven years,
and managed with my student grant (about 500 pounds per year) and the
occasional vocation job (such jobs were like gold dust, for the country
was in financial difficulties).

As a selector for medical admission at the University of Newcastle
for five years in the 1990s I learned about the huge impact that
communication abilities had on the likelihood of selection. In my view
this had a clear disadvantage for working-class applicants.

Two of my sons are in medicine, one graduating in 2010, the other in
third year. They both enjoyed a middle-class upbringing, and were able to
apply to medical school with straight A's, musical qualifications, Duke of
Edinburgh awards and other accoutrements of the middle-class life.
Notwithstanding this, admission to medical school was extremely difficult
and competitive. They entered the world of student loans, fees and
reliance (to their regret) upon parental financial support.

I cannot imagine how my brother and I could possibly have gone
through medical school in these modern circumstances, and without
straightforward state support. I express my heartfelt gratitude day for
the system that permitted me to graduate, and I lament its withdrawal for
those who have followed me. It is ironic that the idyllic system I
describe was in place when the country was much poorer than it is now. If
we are serious about opening up access we need a wholesale rethink.
Academic qualifications are, at least, relatively objective.