At the turn of the century, the majority of students in UK medical schools were white, male and middle-class. Over the past 20 years, though, there has been success for some groups of students in getting through the doors.
Medical schools have made changes to how they admit students, but there are still barriers to success. An increasing number of women and students from black, Asian and minority ethnic (BAME) backgrounds have been admitted to medical school each year. However, there has not been a similar increased representation of students from lower socioeconomic backgrounds, which has remained static at about 10% of all admissions.
Our research shows that to create diversity in medical schools, we need to reconsider the ways we measure this diversity. By considering the experiences of individual students as well as statistics, we can learn how to create routes to success.
One reason to increase the diversity of students admitted to medical school is to increase fairness and equity in educational opportunities for all applicants. Another key reason is to ensure that the future medical workforce will reflect the wide range of backgrounds in the UK population. This will allow the doctors of the future to better meet the healthcare needs of the population they serve.
Making it through the doors of medical school is only one hurdle. There are still challenges to be overcome for students from certain backgrounds in their journey to become a doctor. For example, students from BAME backgrounds are more likely to fail their exams than other students.
These statistics are useful to highlight the differences in admissions and academic achievement between groups of students who can be identified by having specific characteristics, such as a BAME background. But they don’t give more information about the reasons behind the differences. We need to look more closely at the complex factors which lead to student success. This will require research which seeks to understand students’ lives and their experiences of medical school.
Routes to success
We have surveyed a range of studies to consider the ways research into this issue is conducted. This has led us to make some important recommendations about how these differences can be reduced.
Most of the studies we looked at continued to classify students into a specific category, such as BAME background. The findings are then presented as though they are typical of all students within the category.
But only three studies looked at the experience of high-achieving students who had been classified into a single category such as BAME. It is essential to understand the various factors that have contributed to the academic success of these students. This information can then be used to inform future policies, as well as practices, for improving the experience of students from specific backgrounds.
Understanding the factors for success can lead to the development of specific advice services for students from these backgrounds, such as guidance on making medical career choices. The establishment of peer networks and mentors who are students and doctors from a similar background can be very useful.
We also found that only a few studies mentioned that students were actively involved in the research process. Students can be involved in developing questions that are of particular importance to themselves, and can make recommendations for change in how medical schools could improve the learning and support experience of students. A lack of student involvement limits the relevance and value of the findings for future policies and practices. It also restricts the ability of individuals to develop and implement changes that can improve the experiences of all medical school students.
The main findings from our research show that increasing the diversity of students who are accepted to medical school and ensuring their success is still a challenge.
Our recommendations have important implications for all education, including universities, colleges and schools. Each student has their own potential for success and their strengths should be identified and used to improve their own experience, and that of other students.
In schools and colleges, transformational teaching and learning which focuses on the individual aspirations of each student can increase the chances of success for diverse students entering professions like medicine. Once at medical school, students can be supported by mentoring and meeting role models that have successfully navigated the journey through the educational system and beyond.
John Sandars receives funding from Health Education England North West.
Jayne Garner receives funding from the Medical Schools Council..
Prof Jeremy Brown receives funding from Health Education England North West .
Vicky Duckworth does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.