The challenges of widening access to the medical profession: how to facilitate medical careers for those at a genuine disadvantage

Abstract

This article was migrated. The article was marked as recommended. Widening Participation (WP) for medical school entry has been politically encouraged to ensure access and participation for underrepresented groups that are rarely able to gain access to this high demand profession. Those who reside in the 20% most deprived postcodes in Scotland (SIMD20, Scottish Index of Multiple Deprivation) are much less likely to apply for medical school entry and even less likely to succeed. The National outreach programme of Scotland (Reach) aims to rectify the existing situation by encouraging and supporting students from working class backgrounds to apply to high demand courses, including medicine, and has achieved great success in helping pupils from low progression secondary schools to gain a place in Glasgow Medical School. However, some of the Reach students have similar demographics as the rest of the medical school class and arguably do not genuinely belong in the target group. To address this, a second flag, based on SIMD20/40 residence, was employed. Applying more than one WP flag however - while substantially improving the accurate targeting of this programme and helping those who truly are multiply deprived - reduces the Reach-eligible applicant pool to the point of undermining the high WP targets imposed on Universities. But using only a single criterion of SIMD20/40 residence or school progression rate would inappropriately benefit some pupils that are actually not genuinely disadvantaged. Ideally, individualised indicators such as eligibility for Free School Meals, receipt of an Educational Maintenance Allowance and/or a UKCAT bursary, would complement residential data and school progression rates. This paper reflects on the evolution of the admissions practices at Glasgow Medical School that are designed to meet the targets and create a medical workforce reflecting the population it serves.