Is medical school really out of reach for working class students?

A report from the Sutton Trust has highlighted that applicants from working class backgrounds are less likely to apply and be accepted into medical school. This study utilises a simplified ‘NS-SEC’ method, in which an applicant’s class is determined by the occupation of their parents. While these data can be useful, if used on their own and without further context, they do not always provide a full picture of an applicant’s circumstances. For example, NS-SEC may categorise a social worker and a barrister in the same group but a train driver in different group, without any reference to the salary they receive. Many organisations within the higher education sector, including the Medical Schools Council, refer to Indices of Multiple Deprivation (IMD) when trying to understand an applicant’s background. IMD is a geographical measure that focuses on several factors which contribute to a picture of socio-economic deprivation, comprising several domains including income, employment, education, health, crime, barriers to housing and services and living environment. IMD can often provide a more nuanced view of an applicant’s background than the information provided by NS-SEC.

These data highlight that applicants living in areas of greater deprivation find it harder to apply to medical school. Addressing some of these barriers is difficult, especially when many occur before an application is made. However, there are lots of things medical schools are doing to help better support these students.

• Outreach: Building aspirations is important to encourage young people to make an application. As well as local university initiatives, many medical schools are now collaborating to deliver programmes such as summer schools for students from disadvantaged backgrounds.
• Providing better information to applicants: Medical schools are working together to provide clearer information to help demystify the application process. MSC posts entry requirements from all UK medical schools in one place and is working to provide greater advice and guidance in formats suitable for applicants, their parents and their teachers.
• Contextual admissions and gateway programmes: Contextual admissions consider an applicant’s background alongside their academic achievements. Medical schools are working to make these processes more transparent. Many schools also offer gateway programmes for widening participation students and in 2024 there were 19 of these programmes running across the UK.

These interventions usually take time to show impact, but they are leading to real changes. MSC’s recent 10-year progress report on medical school widening participation, Fostering Potential, found that:

• The proportion of medical school entrants from the most deprived areas has more than doubled, from 6% to 14%. This is a 213% increase in the number of entrants since 2013, compared to a 13% increase in the number of entrants from the least deprived areas.

• Entrants from non-selective state schools has increased from 48% to 55%, while the proportion from independent schools has decreased from 29% to 24%. In England, 3.2% of 18-year-olds from independent schools go on to study medicine, compared to 1.9% from state-funded schools.

• The number of schools producing medical applicants has increased from 57% to 64%, while there has been a 32% increase in the number of schools producing entrants.

Despite these positive changes, one-third of schools still do not produce any applicants to medical school, and around half have had no successful entrants.

The MSC report outlines an action plan to address the barriers faced by these applicants and by 2032, medical schools aim to have 33% of students from disadvantaged backgrounds, representing almost 6,000 students annually.

Parental occupation plays an important role in whether an applicant has the resources to be able to make a successful application to medical school. However, this is not reflected in generalised descriptors of class, which can have a negative impact on student perceptions and their ability to see themselves as a doctor. In fact, it is multiple socio-economic factors that need to be considered to understand how applicant background correlates to a successful application and it is essential that this nuance is not lost, both in work to address the issue and the wider public discourse.

Read more about about our work on widening participation: Fostering Potential – 10 years on from Selecting for Excellence.