Excess body weight in people aged 65 and older is associated with greater risk of impaired physical function but not with greater mortality risk. Societies with growing numbers of overweight and obese older people are likely to face increasing burdens of disability-associated health and social care costs.
ContextIn the UK, applications to medicine from those in lower socioeconomic groups remain low despite much investment of time, interest and resources in widening access (WA) to medicine. This suggests that medical schools' core messages about WA may be working to embed or further reinforce marginalization, rather than to combat this. Our objective was to investigate how the value of WA is communicated by UK medical schools through their websites, and how this may create expectations regarding who is 'suitable' for medicine. MethodsWe conducted a critical discourse analysis of UK medical school webpages relating to WA. Our conceptual framework was underpinned by a Foucauldian understanding of discourse. Analysis followed an adapted version of Hyatt's analytical framework. This involved contextualizing the data by identifying drivers, levers and warrants for WA, before undertaking a systematic investigation of linguistic features to reveal the discourses in use, and their assumptions. ResultsDiscourses of 'social justice for the individual' justified WA as an initiative to support individuals with academic ability and commitment to medicine, but who were disadvantaged by their background in the application process. This meritocratic discourse communicated the benefits of WA as flowing one-way: with medical schools providing opportunities to applicants. Conversely, discourses justifying WA as an initiative to benefit patient care were marginalized and largely excluded. Alternative strengths typically attributed to students from lower socioeconomic groups were not mentioned, implying that these were not valued. ConclusionsCurrent discourses of WA on UK medical school websites do not present non-traditional applicants as bringing gains to medicine through their diversity. This may work as a barrier to attracting larger numbers of diverse applicants. Medical schools should reflect upon their website discourses, critically evaluate current approaches to encouraging applications from those in lower socioeconomic groups, and consider avenues for positive change.
Introduction Social comparisons strongly influence an individual's concept of self, their aspirations and decisions. This study investigates how non-traditional applicants used social comparison to shape their preferences, beliefs and predictions whilst preparing an application for medical school. Methods Semi-structured interviews were conducted with 12 UK medical students from non-traditional backgrounds to explore their process of 'getting ready' for medical school, and the role social comparison played in their experiences. Thematic analysis was used to inductively develop themes in the data, before findings were interpreted through the 'triadic model' of social comparison. Results Findings revealed that participants looked to the opinions of those with similar norms and backgrounds to accept their desire to study medicine. They sought the opinions of 'experts' to affirm a belief in their suitability but lacked confidence until success in crucial examinations 'proved', in their own view, that they had the ability to do medicine. Social comparison to peers who were perceived to be less committed to
Context Literature published around a decade ago demonstrated that UK individuals from non‐traditional groups may not consider, or aspire to, medicine because of sociocultural barriers and instead may perceive medicine as ‘not for the likes of me’. Since this time, the UK higher education landscape has undergone significant change, with an increased emphasis on student choice and widening access (WA) initiatives. Consequently, the present study looks anew at the perceptions of medicine held by school pupils from non‐traditional backgrounds to assess whether sociocultural factors remain a major barrier to medicine. Methods Focus groups were conducted with 71 high‐achieving school pupils in their penultimate or final years (aged 16–18 years). Participants attended UK state‐funded schools engaged with medical school WA initiatives. Transcripts were analysed thematically using a data‐driven approach. Themes were then interpreted through the conceptual lens of the ‘reflexive habitus’, an adapted version of Bourdieu's classic concept. Results Participants did not perceive that sociocultural differences would deter them from aspiring to, or pursuing, the career of their choice. Some participants identified their ‘different’ background as a strength to bring to medicine. They reported that intrinsic motivators (personal interest and fulfilment) were most important in their own career choices. When asked what they believed might have motivated current medical students for the career, participants debated the role of extrinsic motivators (high status and income) versus intrinsic ones. ‘Hot knowledge’ (social contacts) from within medicine helped some participants reconcile any clash in perceived values and better imagine themselves in the profession. Conclusions These non‐traditional school pupils from schools engaged with WA initiatives appear to have embraced the belief that medicine is for anyone with the appropriate desire and ability, regardless of background. Furthermore, some pupils reported that some aspects of their ‘difference’ (diversity) could help enrich the workforce and patient care.
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