In order to succeed in medicine, top scores in preparative classes are not always necessary, according the authors of a paper released on May 16, 2008 in BMJ. Instead, they say, students with average grades who come from economically and educationally depressed backgrounds can also do well at medical school, if they are provisioned with additional academic and pastoral support during their first two years.
Traditionally, becoming a doctor has been an undertaking of the professional middle class. Of the conventional medical students, more than three quarters come from this background. However, the authors note that it is acknowledged that the United Kingdom should have doctors whose backgrounds better represent the diverse social and ethnic populations within the country. To this end, participation initiatives have been adopted by most institutions of higher education in the UK.
The paper is written by the people behind just such an initiative, at King’s College London, to analyze their level of success. The Extended Medical Degree Programme (EMDP) was started in 2001 to help enable bright students from low-achieving state schools in Inner London to become doctors. At the program’s inception, ten additional places were made available for these students in each year, and the first group graduated in 2007. The major criterion for acceptance was, rather than the traditional AAB marks, a CCC at the A level.
Students in the program, notably, are allowed an extra year to study. To do this, the five year program’s first two years are spread over three, for a total of six. This year is meant to allow more academic and pastoral support for students. The program also provides additional support including an induction week, student mentors, and personalized training programs.
Most of the EMDP students in the program are the first members of their families to go to university, and come from backgrounds that are different from those of the majority of medical students. Nine out of ten students accepted thus far to EMDP are from ethnic minorities, and just under one third come from middle class families. In the conventional programs, the respective proportions are approximately one half and three quarters.
Despite lower entry grades, the data shows that exam results for these students have been spread fairly evenly throughout their medical school group peers. While first time pass rates have generally been slightly lower, in the clinical years (the latter part of the educational term) the first time pass rates are identical for those in the program and conventional students. For those opting for an intercalated BSc, the rates for EMDP versus conventional students were as follows: 12% versus 28% got a first, 76% versus 65% got an upper second, and 12% versus 7% received a lower second.
Presently, the program encompasses over 200 students and they are doing well, according to the authors. As a result, they say they can safely conclude that, when attending low achieving schools, “medical students can succeed without AAB at A level,” and as a result the efforts to widen participation are creating “a new type of doctor…[that] better reflects the social diversity of London’s population.”
Hugh Ip and Chris McManus contributed an accompanying editorial in which they discuss whether this more diverse population of doctors, which is results from the widening participation initiative, will actually better serve a diverse population of students. Additionally, they question if the program is an appropriate use of the £190,000 ($370,000 USD) it costs each year.
Widening participation in medicine
Pamela B Garlick, Gavin Brown
BMJ Volume 336 pp 1111
Increasing diversity among clinicians
Hugh Ip, Chris McManus
BMJ Volume 336 pp 1082
Written by Anna Sophia McKenney