Only 5% of students in medical schools from lowest socio-economic group
A small number of schools and colleges produce a high number of applicants to medical school, according to research by the Sutton Trust.
Applicants from private schools were 1.5 times more likely to receive an offer to study medicine compared to those from non-selective state schools, the study suggested.
The report, which includes an analysis of nearly 94,000 applicants in England to UK medical schools between 2012 and 2022, found just 5% of entrants were from the lowest socio-economic group in 2021.
In contrast, 75% of entrants to medical schools were from higher socio-economic backgrounds in 2021, according to the research.
While still low, the proportion of those from lower socio-economic backgrounds has doubled since 2012, the report said.
The study used the National Statistics Socio-economic Classification (NS-SEC) groupings of parental occupation to determine the socio-economic status of applicants.
Applicants from lower and intermediate socio-economic backgrounds were 'less likely' to get an offer than their better-off peers, according to the report which included an analysis by University College London (UCL) academics.
The study found that a 'major factor' in this was prior educational attainment, as these students had, on average, lower GCSEs, predicted A-levels, and lower results on the University Clinical Aptitude Test (Ucat) for medical schools.
The Ucat test may be a 'barrier' for those from worse-off homes, according to the Sutton Trust report.
Standard entry A-level requirements range from AAA to A*A*A in all medical schools bar one – with one of the new medical schools asking for AAB.
But the report found that most medical schools now give some kind of contextual offer for applicants from under-represented backgrounds – and an increasing number have introduced alternative entry routes to medicine.
Seventeen medical schools have 'gateway' courses – which have lower grade requirements for eligible applicants and an additional foundation year before the standard medical school programme.
The lowest contextual offers at some medical schools is BBB for participants in their own access to medicine programmes, according to the research.
Of the 2,719 schools or colleges that put forward any medical applicants between 2012 and 2022, the study found that the majority (80%) had few students applying for medicine – at five or fewer per year.
But 58 schools or colleges – comprising just 2% of all institutions – had an average of 20 or more applicants per year.
One had more than 850 applicants over the 10-year period – an average of 85 applicants per year.
Even after adjusting statistically for their exam grades, socio-economic status and other demographic factors, private school applicants had higher odds of receiving an offer than those from non-selective state schools, the report said.
The charity is calling for the Government to prioritise medical schools with a successful, widening participation record in any expansion of spaces to improve the socio-economic mix of students.
Medical schools should be properly resourced to fully support students from lower socio-economic backgrounds and they should make more ambitious use of contextual offers and review their use of Ucat in admissions, it added.
Nick Harrison, chief executive of the Sutton Trust, said: 'It's outrageous that working-class kids make up just 5% of medical students, especially when the NHS is facing a chronic shortage of doctors and a heavy reliance on overseas recruitment.
'The medical profession is stretched to breaking point, and urgent action is needed to widen access and create a more diverse pipeline of talent from all parts of society.
'Patients benefit from doctors who reflect the diversity of the communities they serve, but it's clear that we're a long way from that today.
'If you have the ability, where you grow up or your parents' income shouldn't be a barrier to becoming a doctor.
'Working-class entry into medicine is in a critical condition. The profession urgently needs a shot of equality.'
Professor Katherine Woolf, professor of medical education research at UCL Medical School, said: 'Despite the many changes medical schools have made over the past decade to improve access to the profession, our research has shown low prior attainment remained a major barrier to many aspiring doctors from the poorest backgrounds.
'Providing enough doctors to meet the country's needs will require better support for future doctors, especially those from disadvantaged backgrounds.
'This support is needed at all stages of a doctor's career: from school, before and during application to medical school, and throughout the many years of medical education and training that are essential to practise as a doctor.'
Ohemaa Asare, British Medical Association (BMA) medical students committee deputy co-chair (widening participation), said: 'These results are hugely disappointing but unfortunately not surprising as there is still a very long way to go to ensuring medicine is more accessible to students from underrepresented or disadvantaged backgrounds.
'It is such a shame that there are many aspiring and talented doctors of the future who could make a valuable contribution to medicine and the NHS but are being hindered by many hidden barriers.'
Clare Owen, director of education at the Medical Schools Council (MSC), said medical schools have made 'significant progress' in widening participation over the past decade.
She said: 'Entrants from deprived areas have doubled to 14%, and state school representation has risen from 47% to 54%. Meanwhile, independent school acceptances have dropped from 29% to 24%.
'However as noted in the Sutton Trust study, students from lower-socio-economic backgrounds still face challenges.'
A recent report outlined the MSC's action plan to address such barriers, including: developing targeted widening participation programmes and exploring the potential of contextual admissions.
Ms Owen added: 'By 2032, medical schools aim to have 33% of students from disadvantaged backgrounds, representing almost 6,000 students annually.
'Achieving this goal will require a sector-wide effort, and we look forward to working closely with the Sutton Trust and other key stakeholders to improve access to the medical profession.'
A Government spokesperson said: 'While we inherited an education system with a number of baked-in inequalities, our ambitious Plan for Change sets out our clear mission to break the link between background and success.
'We will act to address the persistent gaps for different student groups and to break down the barriers to opportunity.
'While we have announced a 3.1% increase in loans for living costs for 2025/26, it's vital that all HE providers play a strong role in expanding access and improving outcomes for disadvantaged students.
'This Government is committed to growing our own homegrown talent, and training thousands more doctors.
'We will work with partners including NHS England and the university sector to ensure that everyone has an opportunity to study medicine – regardless of their background.'
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