Medical school access `dominated by most affluent’, says new study

Access to medical school across the UK is still dominated by students from more affluent parts of society, a new study led by the University of Dundee has shown.

The study has revealed considerable variation between the four UK nations and between different medical schools.

Researchers from the Universities of Dundee and Central Lancashire analysed application data for 22 medical schools and around 30,000 applicants across the UK for the three years from 2009-10 to 2011-12, The study was supported by the UK Clinical Aptitude Test consortium ( ) which provided data.

The results are published in the journal BMC Medical Education (see

The study looked at socioeconomic status using postcode data for applicants, school type and parental occupation.

Medical students have historically largely come from more affluent parts of society, leading many countries to seek to broaden access to medical careers on the grounds of social justice and the perceived benefits of greater workforce diversity.

However, the new study shows marked differences across the social gradient of applicants. Depending on which UK country they were from, between 19.7% and 34.5% of applicants lived in the most affluent tenth of postcodes, as opposed to only 1.8-5.7% in the least affluent tenth of areas.

The inequality between the most and least affluent appears to be greatest in Scotland, Wales and Northern Ireland, with England appearing to have the most equitable distribution of applicants, although researchers say comparisons between countries are difficult because they measure affluence and deprivation differently.

However, the majority of applicants in all postcodes had parents in higher end occupations. A quarter of people in the UK are in the two lowest occupational groups, but only one in twenty medical applicants had parents in these occupations.

There was also a higher rate of applications from students at independent schools as opposed to state schools.

“Regardless of which measure you look at, those coming from less affluent backgrounds are much less likely to apply to study medicine, and those that do apply are somewhat less likely to be offered a place at medical school,” said Professor Bruce Guthrie, of the University of Dundee Medical School.

“One of the major implications arising from our results is that they show that modifying selection processes is unlikely to have a major impact on widening participation because so few people from less affluent backgrounds apply in the first place.

“There is a large variation between medical schools in terms of the applicants they attract, and the proportion of applicants from less affluent backgrounds who get a firm offer of a place. This may indicate that some medical schools have implemented effective strategies to widen participation. However, there needs to be better understanding of why these differences exist and how best practice can be shared.

“Admission to medical school determines the composition of the medical profession in the future and, based on our analysis, medicine in the UK will remain dominated by those from more affluent backgrounds.

“There is no quick fix to widening participation, partly because gaining a place remains, rightly, largely determined by academic ability.”

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