“It’s going to be hard you know…” Teachers’ perceived role in widening access to medicine

Abstract

Medical schools worldwide undertake widening access (WA) initiatives (e.g. pipeline, outreach and academic enrichment programmes) to support pupils from high schools which do not traditionally send high numbers of applicants to medicine. UK literature indicates that pupils in these schools feel that their teachers are ill-equipped, cautious or even discouraging towards their aspiration and/or application to medicine. This study aimed to explore teachers' perspectives and practices to include their voice in discussions and consider how medical schools might best engage with them to facilitate WA. Interviews were conducted with high school teachers in three UK regions, working in schools targeted by WA initiatives. Data were analysed thematically using template analysis, using a largely data-driven approach. Findings showed that although medicine was largely seen as a prestigious and worthwhile career, teachers held reservations about advocating this above other choices. Teachers saw it as their role to encourage pupils to educate themselves about medicine, but to ultimately allow pupils to make their own decisions. Their attitudes were influenced by material constraints in their schools, and the perception of daunting, long and emotionally difficult admissions requirements, with low chances of success. Medical schools may wish to work with teachers to understand their hesitations and help them develop the mindset required to advocate a challenging and unfamiliar career, emphasising that this encouragement can further the shared goal of empowering and preparing pupils to feel capable of choosing medicine. Reciprocally, medical schools should ensure pupils have fair opportunities for access, should they choose to apply.

Cultures of Success: How elite students develop and realise aspirations to study Medicine

“…There's that whole notion of not wasting your ATAR. (P7) While the perception that Science and Medicine are difficult is a disincentive for many students (Alexander et al, 2021;Aschbacher et al, 2010), at Blair, the perceived difficulty of these fields, and their connection to the social prestige and onerous university entrance requirements of Medicine, encouraged students to pursue them. This mirrors Wong's (2012) finding that British Asian students pursued advanced Science, not necessarily out of intrinsic interest in these subjects, but in order to perform a "clever" and "high achieving" identity.…”

Drastic Times Need Drastic Measures: Covid-19 and Widening Access to Medicine

“…School teachers are recognised as a key pathway through which pupils access information and initiatives about medical schools and medicine 35 but research from Scotland and other countries show that teachers from state schools lack information and do not encourage aspiration to medicine in pupils from less traditional backgrounds. 4,7,36,37…”

“…2,5 Socioeconomic background (SEC) refers to an individual's or family's economic and social position in relation to others, based on income, education and occupation. Potential applicants from lower SEC groups already experience disadvantages, for example in education quality and attainment (see above); fewer economic and familial resources; 6 poor careers guidance; 7 and lack of knowledge about medical admissions requirements and processes. 8 These are all disadvantages which will be exacerbated by COVID-19 restrictions.…”

Follow the policy: An actor network theory study of widening participation to medicine in two countries

“…[1][2][3][4][5][6][7][8][9][10] The central reason for the slow pace of change is that prior educational attainment remains the first, and sometimes only, hurdle in medical school selection processes (see, e.g., MacKenzie et al 11 ), excluding students who do not "get the grades" even if they have the appropriate personal qualities to become doctors (e.g., previous works 4,5,11,12 ). This dependence on academic achievement is problematic on grounds of fairness given differential attainment between groups associated with structural and societal issues such as under-resourced education, schooling that occurs within a culture of low aspiration and parental education (e.g., previous studies [12][13][14][15][16][17][18] ).…”

“…Maintaining the practice of academic excellence as a keystone for entry to medical school while advocating increasing the diversity of medical students represents a tension between practice and policy, and hints at powerful actors reproducing practices that support the status quo. 17,[19][20][21][22] Exploring the role played by policy in this area is thus essential to identify how it encourages certain practices over others. To do so requires acknowledging the agency of policy (a non-human actor), and how educational policy and practices relate.…”