Medical school should not be the preserve of the eliteBMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i1950 (Published 13 April 2016) Cite this as: BMJ 2016;353:i1950
We all need to do more to encourage students from disadvantaged areas to apply to medical school, says Patrice Baptiste
I was not surprised to read an article in BMJ Careers about disadvantaged pupils being less likely to apply to medical school.1 I could pre-empt much of the discussion, having studied at a comprehensive school in a “disadvantaged” area myself.
The article was based on a retrospective analysis of data collated from 22 UK medical schools between 2009 and 2012.2 The study showed that there were more applicants from the wealthiest areas and from independent schools than from more underprivileged areas and state schools. So, despite only 7% of students in the UK studying at private schools, more are applying and being accepted into medical school.3
It is absurd to have doctors come from one narrow social group, when they may have no understanding of the issues faced by those from other backgrounds. Of course this can be applied to many other professions such as politics or journalism.
Universities have tried to broaden participation through various schemes, to some effect.4 A marked disparity still exists, however, and there needs to be more effective initiatives across all medical schools.
Needing a plan
I studied at University College London medical school despite attending a comprehensive school in Waltham Forest. Out of the four students who applied to medical school that year, I was the only one to secure a place at a top London university.
I have always wanted to become a doctor. Growing up I knew the challenges that I faced and I sought out ways to overcome them. My parents had good jobs and worked hard but they were not well connected and could not afford to send me to a private school. Although my school has improved substantially since I was there, at the time it did not provide what I needed. The teaching was satisfactory but, as with any comprehensive, large classes meant that I could not always get the help that I needed. Many students in my class were not focused on learning and tried to distract those that were.
I realised that I needed a plan. I knew I had to be several steps ahead academically so my parents hired a tutor to help me excel in certain areas and also to focus on those areas I wasn’t so good in.
The next step was to work on the essential non-academic criteria. I did not know any doctors in my immediate family or in my circle of friends but I was fortunate that my Dad worked as an operational department assistant and I was able to secure a week at his hospital.
The head of my sixth form organised a day at the Royal Society of Medicine where I learnt about becoming a doctor. She also organised two mock interviews—one of which was conducted at a local private school.
Letting students know that it is possible
My experience of the application process is still clear in my mind and I remember how determined I was to level up the uneven playing field that I faced. Many students from disadvantaged backgrounds want to become doctors but they simply do not know where to turn. Now, as a qualified doctor, I visit local schools to speak to students. I want them to see that I was once in their position, working hard to achieve my dream. I want them to realise it is possible, but that it does not come easily.
Many of the students I meet tell me that they need more support with the application process. Securing work experience without a contact can be extremely difficult. Students are also concerned about rising university tuition fees, the amount of debt they will have after graduation, and how the imposition of the junior doctor contract will affect them.
Some students would like to study medicine but are discouraged from applying because their grades are not good enough. Of course it would be wrong to encourage a student falsely, but has that student been given all the support possible to achieve the necessary grades? Many bright and capable students lack confidence and this problem can be compounded by their school.
Students need to realise that medicine is a realistic option for them. They need support to achieve the qualifications and be encouraged rather than discouraged from applying. Schools, parents, the government, universities and hospitals need to work together.
All doctors—especially those who come from disadvantaged backgrounds—have a moral responsibility to help students. Students need guidance when choosing a career, especially when they have no idea what that career consists of. A lot of the students I have spoken to do not really know what a doctor does or how the NHS works. How can we expect those students to enter into such a challenging career when they have no true understanding of what lies ahead of them?
I have read and understood the BMJ Group policy on declaration of interests and declare that I have none.