The BMA has issued a warning that students from deprived areas in the country may be ‘held back from a career in medicine’, because most medical schools require a GCSE in Triple Science in order to apply. This award was found not to be offered as often in deprived areas, and when it is offered, lower numbers of students applied for it. The BMA have called for all secondary schools to offer Triple Science as a course, for medical schools to consider contextual data (like details about the applicant’s school or where they live) in their admissions, and also for outreach schemes between medical schools and secondary schools to spot possible talent early on.

I must admit, I don’t remember my own Triple Science classes being that under-subscribed. I went to school in the Warwickshire town of Nuneaton. Nine areas in Nuneaton are featured in the 10% most deprived communities in the country, according to a report from Warwickshire Observatory from 24th March, 2015. For clarification, I don’t live in any of those nine areas, and I would not refer to myself as deprived by any stretch; however many of the people from my school came from these areas. Students at Higham Lane School (which I attended 2005-2010) were- and still are, as far as I know- offered the chance to do the Triple Science GCSE. Several people I know from school have gone on to medical schools and are currently in training to be doctors, although I would estimate that most of these people did come from middle-class households.

That disclaimer aside, it is important to remember that one anecdotal case does not a rule make. The BMA’s report, ‘The Right Mix: how the medical profession is diversifying its workforce’, found that in the areas of Hull and Newcastle, less than 65% of schools offer the Triple Science course. In Newcastle, only around one in five students were taking the course (18%); in Hull, this was significantly lower, at around one in ten (11.4%). Compare this to Rutland, an area significantly more well-off than those mentioned, in which over a third of students (36.2%) study the subject, which is taught at all schools in the area. 80% of applicants to medical qualifications in the UK come from 20% of the schools, so one must cross their fingers and hope that the next Sir Alexander Fleming hasn’t had the misfortune to be born in Hull (sorry, Hull).
A possible problem is the perception of medical schools by people of lower socioeconomic class. A 2004 study published in the BMJ and co-authored by Professor Trisha Greenhalgh found that opinions of medical school didn’t change much when considered by gender (over half of medical students in 2013 were female) or by ethnicity. Class on the other hand had a significant effect:
Pupils from lower socioeconomic groups held stereotyped and superficial perceptions of doctors, saw medical school as culturally alien and geared towards “posh” students, and greatly underestimated their own chances of gaining a place and staying the course. […] Pupils from affluent backgrounds saw medicine as one of a menu of challenging career options with intrinsic rewards[.]
Source: PubMed Central
The study also found that while both groups were concerned about the costs of study, only the poorer pupils saw it as a factor of constraint.
There is a clear and obvious problem in the country today with the perception of the medical profession. With the current crises of under-staffing in hospitals across the country, it is also a potential time-bomb for the NHS. The recent furore over junior doctors and their salary cuts, along with Jeremy Hunt’s push for an ill-planned 24/7 NHS (as many infuriated medical staff have already pointed out, doctors already work weekends) will likely turn people off the profession, especially potential future doctors from lower socioeconomic backgrounds who, even back in 2004 according to the Greenhalgh study, already considered the profession to require ‘prohibitive personal sacrifices’.
A push needs to be made to attract as many people to the profession as possible from all backgrounds. An anti-propaganda campaign to the Tories’ poisonous rhetoric and restrictive policies towards the poorer community’s ability to study needs to be orchestrated. As well as this (as the BMA rightly says), there needs to be a effort to make these opportunities available and viable for everyone. This involves being outraged by the fact that many students can no longer afford their own rent while studying; this includes providing as much support for reforming the student loan system as possible; this means providing an information campaign directed at pupils in deprived areas to educate them that careers in medicine are in reach, that they are attainable with hard work and dedication, and that the rewards from such endeavours stretch far wider than just financial incentives.
It’s saving lives, at the end of the day, in the most literal sense.




