Abstract

Widening Participation (WP) in medicine refers to all theory, activities and policy concerned with removing barriers to entering medical school for students from lower income and under-represented backgrounds. Medical schools and other institutions including; the Medical Schools Council, the Office for Fair Access, the Higher Education Funding Council for England, have been committed to improving Widening Participation for more than a decade. As senior medical students and academics, we have been actively involved with WP work at our respective medical schools and in conjunction with the British Medical Association (BMA) and the Medical Schools Council (MSC). Yet, we have observed over the years that the pace of change seems sometimes stuttering and stagnated. Here, we have investigated the reasons why there is still such a significant under-representation of students from lower income backgrounds in medicine. In order to make the medical student intake representative of the general population, the number of applications from lower income students would need to increase five-fold. This would require a great scaling up of WP outreach work. Critical analysis demonstrates that medical schools and the other key institutions in medical education have made many nominal commitments to WP, but have yet to make any commitments that are truly binding. This may be due to the institutions lack of belief in their own capacity to scale up WP Outreach sufficiently to achieve success. Ultimately binding commitments will be needed to secure a representative intake of medical students. In order for institutions to be willing to move towards such commitments, evidence-based success in WP must first be demonstrated through collaboration on specific projects that are scalable, sustainable and impactful.