Investigating the challenges of widening access in medical education

Abstract

Students from non-traditional backgrounds are under-represented in UK medical schools. Despite measures to support potential applicants from this cohort, applications and subsequent enrolment on medical courses remain one of the lowest of any professional degree in the UK. Those students from non-traditional or historically under-represented backgrounds (HUB) that do successfully obtain a place at a UK medical school are also at greatest risk of non-completion.

This thesis investigates the challenges of widening access to medical education by looking at the decision making processes and application experiences of students considering a career in medicine and on-course experiences of medical students. It uses a mixed methods approach to identify application, offer and non-completion trends alongside incorporating accounts from students that have experienced the process and the perspectives of teachers that support the pre-entry process.

Findings indicate that, whilst the application process for medical education is a challenging process for all applicants, there are additional challenges faced by HUB students including timely and accurate information, advice and guidance and access to support networks. Of those that do successfully navigate the application and selection process, HUB students are most likely to struggle with transition into the medical school environment and to drop out of the course.

This thesis also aims to explore the effect and efficacy of different metrics that are used to assess whether a student classes as disadvantaged for the purposes of classifying them into a widening participation (WP) or non-WP category. By testing five metrics that are commonly used for this purpose, the thesis shows that using just under-representation metrics omits trends that using deprivation metrics capture, and vice-versa.

Overall this thesis identifies several factors that may be hindering efforts to widen access to medical education, bringing together issues affecting HUB students right across the student lifecycle to inform best practice.