Private School Applicants More Likely to Get Medical Offers

Despite efforts to diversify, only a small fraction of UK medical students come from working-class backgrounds, new research showed.

Private school applicants are 1.5 times more likely to receive medical school offers than those from nonselective state schools, according to a study by social mobility charity, the Sutton Trust. This disparity persists even after adjusting for exam results, socioeconomic status, and other factors.

In 2021, just 5% of new medical school entrants were from the lowest socioeconomic backgrounds, while 75% came from higher socioeconomic groups, the analysis found. 

Of the 2719 schools or colleges that supplied medical applicants between 2012 and 2022, 80% sent fewer than five per year whereas 2% contributed at least 20 annually. 

Kevin Latham, research and policy manager at the Sutton Trust, told Medscape News UK that the admissions data highlights inequalities in access to medical schools. “It’s unfair that certain groups in society should find it more difficult to enter that profession than others, not because they are less capable but because of the particular family circumstances they were born into,” he noted.

Latham stressed that the medical workforce should better reflect societal demographics. “Research has shown that patient experiences are more positive where there is better understanding of their backgrounds,” he said.

Barriers to Entry

The study analysed almost 94,000 applicants to UK medical schools between 2012 and 2022, representing around half of all applicants during this period.

It found that those from lower and intermediate socioeconomic backgrounds were less likely to receive an offer than more affluent peers, largely due to differences in prior educational attainment.

Applicants from disadvantaged backgrounds tended to have lower GCSE grades, lower predicted A-level grades, and lower scores on the University Clinical Aptitude Test (UCAT), a standardised test used in medical school admissions.

Even among those with the highest predicted A-level results, applicants from lower socioeconomic backgrounds scored 5% lower on the UCAT than their more affluent peers.

Efforts to Improve Diversity

Several initiatives have aimed to increase diversity in medical school admissions over the last two decades. Between 2018 and 2021, for example, six new medical schools opened in areas with relatively few doctors per person. These schools recruited more students from under-represented groups.

While around 25% of entrants to established medical schools were privately educated, only 10% of entrants to these new institutions were from private schools. However, just 7% of entrants came from the lowest socioeconomic backgrounds, while two thirds were from the highest.

Gateway medical degree courses, introduced in the early 2000s, also aim to attract applicants from under-represented backgrounds. These programmes include an additional foundation year and have lower entry requirements. Altogether, around 11% of entrants to these courses were from the lowest socioeconomic backgrounds, while 46% were from the highest.

“While this is better than standard entry courses (where the figures were 4% and 73%, respectively), gateway courses may need to do more to further access to those from lower socioeconomic backgrounds,” the researchers wrote.

Equitable Access

Latham highlighted initiatives by the Sutton Trust to support aspiring doctors from disadvantaged backgrounds. These include multiyear in-person programmes, residential courses, and personalised online support. “These aim to support students to make informed decisions about their future careers and facilitate their progression to highly competitive universities and courses,” he said.

Clare Owen, director at the Medical Schools Council (MSC), told Medscape News UK that the MSC aims to recruit 33% of students from disadvantaged backgrounds by 2032. This would amount to nearly 6000 students per year.

She added that the MSC currently supports medical schools to achieve greater transparency in their application processes and encourages the use of contextual data when making decisions on admissions. It is also addressing issues such as student financing and fostering inclusive environments in medical schools, she said.

Future Recommendations

Latham called for government policies that prioritise medical schools with a strong track record of widening participation. “We also want to see more ambitious use of contextual offers from medical schools, and better collaboration between medical schools, for instance with greater mutual recognition of each other’s widening participation programmes.”

According to Latham, “There should also be less reliance on area-based measures in widening participation criteria and more attention to individual-based measures such as eligibility for free school meals.”

Owen outlined further steps to improve access, including targeted recruitment efforts and outreach to schools in under-doctored areas.

“Medical schools are committed to widening participation. We want to recruit from a diverse talent pool so that anyone with the potential to be a good doctor has the opportunity to do so,” she said.

Annie Lennon is a medical journalist. Her writing appears on Medscape.co.uk, Medical News Today, and Psych Central, among other outlets.