The challenges of widening access to the medical profession: how to facilitate medical careers for those at a genuine disadvantage

Widening Participation (WP) for medical school entry has been politically encouraged to ensure access and participation for underrepresented groups rarely able to gain access to this high demand profession. Those who reside in the 20-40% most deprived postcodes in Scotland (SIMD20) are much less likely to apply for medical school entrance, and even less likely to succeed. The National Reach programme in Scotland aims to rectify the existing situation by encouraging and supporting students from working class backgrounds to apply to high demand courses, including medicine, and has achieved great success in helping pupils from target secondary schools to gain a place in Glasgow Medical School. However, some of the Reach students have similar demographics to the rest of the medical school class and arguably do not genuinely belong in the target group. To address this, a second flag based on SIMD20 residence was employed. However, applying more than one WP flag - while substantially improving the targeting of this programme and helping those who truly are multiply deprived - reduces the Reach-eligible applicant pool to the point of undermining the high WP targets imposed on Universities. But using only a single criterion of MD20 residence or school progression rate would unfairly advantage some pupils that are actually not disadvantaged. Ideally, individualised indicators such as eligibility for Free School Meals, possession of an Educational Maintenance Allowance or receipt of a UKCAT bursary, would complement residential data and school progression rates. This paper reflects on the evolution of the admissions practices in our medical school designed to comply with the targets, but also create a medical workforce reflecting the population it serves