Shut out: the medical profession’s intractable class problemBMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6433 (Published 14 November 2019) Cite this as: BMJ 2019;367:l6433
- Caroline White, freelance journalist, London, UK
In 2012 the UK government’s social mobility adviser lambasted the medical profession. Too few people from socially and educationally disadvantaged backgrounds were being encouraged to become doctors, Alan Milburn said.1
In response, five years ago the Medical Schools Council’s Selecting for Excellence project made recommendations to tackle the problem and shed the profession’s image as an enclave of privilege. But since 2014 progress has been slower than in higher education overall, despite efforts by medical schools to boost the intake of disadvantaged students. One challenge is that there is no one measure of disadvantage, with proxies including having been in care, attending a poorly performing school, or living in a deprived area.
Little significant improvement
UK universities currently spend £800m (€930m; $1bn) a year on various initiatives to widen participation to all under-represented students. Medical schools now provide 19 “gateway” courses that include an extra initial year for able students who have faced additional educational hurdles because of their circumstances. And some use contextual offers, which lower academic entry requirements for able students.
The Medical Schools Council’s annual report on widening participation from last December concluded that although “very good progress” had been made on approaching equality between men and women in the profession and on increasing ethnic diversity, “more progress is needed for other demographic variables associated with social and educational disadvantage. Despite modest changes in some . . . there is little significant improvement.”2
In 2016 two fifths (41%) of new medical students were of black or other minority ethnic backgrounds, compared with 25% in higher education overall, although Bangladeshi and black Caribbean students remained …