A report from The Sutton Trusts finds that the proportion of medical students from the lowest socio-economic backgrounds still accounts for just 5% of entrants.
The Sutton Trust has said that only a fraction of medical students are from working class backgrounds despite efforts to widen access to the profession.
The research finds that although the proportion of medical students from the lowest socio-economic backgrounds more than doubled since 2012, they still account for just 5% of entrants in 2021.
In contrast, three-quarters were from higher socio-economic backgrounds, based on their parents’ occupation.
“It’s outrageous that working-class kids make up just 5% of medical students, especially when the NHS is facing a chronic shortage of doctors and a heavy reliance on overseas recruitment. The medical profession is stretched to breaking point, and urgent action is needed to widen access and create a more diverse pipeline of talent from all parts of society. Patients benefit from doctors who reflect the diversity of the communities they serve, but it’s clear that we’re a long way from that today,” said Nick Harrison, chief executive of the Sutton Trust.
“If you have the ability, where you grow up or your parents’ income shouldn’t be a barrier to becoming a doctor. Working-class entry into medicine is in a critical condition. The profession urgently needs a shot of equality,” he continued.
Offers for independent schools
Data was analysed on nearly 94,000 applicants to UK medical schools between 2012 and 2022, representing around half of all UK medical applicants. It showed that a relatively small number of schools and colleges provided a very high number of medical students. Of the 2,719 schools or colleges that provided any medical applicants between 2012 and 2022, most only had one applicant per year and 80% had fewer than five per year. But 58 schools and colleges, comprising just 2% of all institutions, had an average of 20 or more applicants a year. One had more than 850 applicants over this 10-year period, with an average of 85 applicants a year.
Applicants from independent schools were 1.5 times more likely to receive an offer to study medicine compared to those from non-selective state schools. Even after adjusting statistically for their exam grades, socio-economic status and other demographic factors, independent school applicants had higher odds of receiving an offer.
Overall, applicants from lower and intermediate socio-economic backgrounds were less likely to get a medical school offer than their better-off peers.
The report suggests that the University Clinical Aptitude Test (UCAT) for medical schools may have contributed to this, as it could have posed an additional barrier for those from worse-off homes. Applicants from lower socio-economic backgrounds with the highest predicted A Level points achieved significantly lower UCAT cognitive scores than those from medium or higher socio-economic backgrounds – by the equivalent of 125 UCAT points, or 5%, in 2022.
Some positive changes
The report did suggest that there have been some positive changes to admissions processes, such as the increased use of contextual admissions by medical schools, where a university considers an applicant’s academic performance in light of their background and circumstances.
At King’s College London, for example, contextual offers may be up to two A-Level grades (or equivalent) lower than the advertised entry requirements, which is A*AA for medicine.
Admissions approaches, however, vary considerably between medical schools and there is a lack of transparency about admissions criteria on some of their websites. This can make it difficult for applicants to understand to which medical schools they should best apply.
“Medical schools are working hard to increase the representation of disadvantaged students,” wrote Katie Petty-Saphon, chief executive of the Medical Schools Council in a letter to The Guardian. She pointed out that they have a goal of 33% of students from disadvantaged backgrounds by 2032 – around 6,000 students annually.
Achieving this target requires what she described as “sector-wide” collaboration. “It is crucial that the nuances of widening participation are properly communicated, both in efforts to address the issue and in the broader public discourse,” she concluded.
