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Widening access to medical education for under-represented socioeconomic groups: population based cross sectional analysis of UK data, 2002-6

BMJ 2011; 342 doi: (Published 22 February 2011) Cite this as: BMJ 2011;342:d918
  1. Jonathan Mathers, research fellow,
  2. Alice Sitch, research fellow,
  3. Jennifer L Marsh, lecturer,
  4. Jayne Parry, professor of policy and public health
  1. 1School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, West Midlands, B15 2TT, UK
  1. Correspondence to: J Parry J.M.Parry.1{at}
  • Accepted 24 November 2010


Objective To determine whether new programmes developed to widen access to medicine in the United Kingdom have produced more diverse student populations.

Design Population based cross sectional analysis.

Setting 31 UK universities that offer medical degrees.

Participants 34 407 UK medical students admitted to university in 2002-6.

Main outcome measures Age, sex, socioeconomic status, and ethnicity of students admitted to traditional courses and newer courses (graduate entry courses (GEC) and foundation) designed to widen access and increase diversity.

Results The demographics of students admitted to foundation courses were markedly different from traditional, graduate entry, and pre-medical courses. They were less likely to be white and to define their background as higher managerial and professional. Students on the graduate entry programme were older than students on traditional courses (25.5 v 19.2 years) and more likely to be white (odds ratio 3.74, 95% confidence interval 3.27 to 4.28; P<0.001) than those on traditional courses, but there was no difference in the ratio of men. Students on traditional courses at newer schools were significantly older by an average of 2.53 (2.41 to 2.65; P<0.001) years, more likely to be white (1.55, 1.41 to 1.71; P<0.001), and significantly less likely to have higher managerial and professional backgrounds than those at established schools (0.67, 0.61 to 0.73; P<0.001). There were marked differences in demographics across individual established schools offering both graduate entry and traditional courses.

Conclusions The graduate entry programmes do not seem to have led to significant changes to the socioeconomic profile of the UK medical student population. Foundation programmes have increased the proportion of students from under-represented groups but numbers entering these courses are small.


  • Contributors: This work was undertaken as an extension of the evaluation of the national expansion of medical schools project of which JP was principal investigator. JP and JM jointly conceived the idea for the current analyses. JP undertook the data cleaning and initial analyses and wrote the first draft, which was subsequently commented on substantially by JM. JLM and AS contributed to the analysis and interpretation of findings and revisions of the manuscript. JP and JM are guarantors.

  • Funding: This study was funded by the Department of Health Policy Research Programme and the Higher Education Funding Council for England (Evaluation of the National Expansion of Medical Schools project; No 0160056). The design and conduct of the research and analysis and interpretation of data was undertaken independently by the authors.

  • Competing interests: All authors have completed the Unified Competing Interest form at (available on request from the corresponding author) and declare: no support from any organisation for the submitted work, apart from that mentioned above; all authors are employed by the University of Birmingham, which admits graduate and undergraduate students to its medical programmes; no other relationships or activities that could appear to have influenced the submitted work.

  • Ethical approval: The study was approved by the West Midlands multi-centre research ethics committee (No 04 ⁄ MRE07⁄ 58).

  • Data sharing: No additional data available.

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