Intended for healthcare professionals

Rapid response to:


State educated children do better at medical school

BMJ 2017; 358 doi: (Published 11 September 2017) Cite this as: BMJ 2017;358:j4239

Rapid Response:

Re: State educated children do better at medical school

Adrian O Dowd’s 17 September article: State Educated Children Do Better at Medical School highlighted that those state educated pupils who reach university outperform peers at medical school. The article correctly noted that whilst there has been improvements in access by gender, age and ethnicity, socio-economic factors remain a barrier.

Sadly this should come as no surprise; as long ago as 2012 the government commissioned report Fair Access to the Professions (aka the Milburn report) showed that only 7% of medical students came blue collar or unemployed family backgrounds.

Paradoxically governments since 2010 have concluded that the answer to lower participation by economically disadvantaged groups should been to treble tuition fee debts (2012), break promises on raising the tuition fee repayment threshold in line with inflation (2015) and to abolish maintenance grants (2016). It is therefore no wonder that UCAS figures shows a 13% drop in the number of students applying to studying medicine and dentistry since 2013.

Sadly the government shows no sign of gleaning any insight from the link between debt and participation in medical careers. Instead it has blundered ahead yet again and abolished the bursary for nursing students such that nursing applications are down more than 20% this year.

I hope one day the government will learn from our near neighbours such as Germany and Holland who respectively have no or very low tuition fees. It is heart-warming to hear that state school pupils are outperforming in medicine. We should mourn for all those bright students who never make it to day one of medical school due to the prospect of debts that can surpass £100k.

see pg 42 The 2012 Milburn Report/Fair Access to the Professions )

UCAS Statistics on application cycles up 30 June 2017

Nursing times article on nursing applications

BMA blog on medical student debt (written when I was chair of the BMA Medical Students Finance Committee 2014-16)

Competing interests: No competing interests

18 September 2017
Dr Tom W Rock