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At the heart of general practice since 1960

We must increase diversity at medical school

Dr Patrice Baptiste

News that the Government wants to increase the proportion of students from disadvantaged backgrounds, as part of plans to expand the number of medical school places, is welcome, but how realistic and achievable is it?

My experience going through medical school and now training as a GP has reinforced my belief we need to increase diversity at medical school to make the best of our talent, and in turn help to rejuvenate general practice.

It was a dream come true when I received my offer to study medicine at UCL during 2007. I still remember the excitement and apprehension when I began my first week at medical school. I realised even then the magnitude of what I had achieved, both in terms of my ethnicity and my social background. Ten years on, I would argue that for students similar to myself, the struggle to secure a place at medical school is just as tough.

Looking at the breakdown of ethnicities studying medicine reveals a stark variation. Figures from the Health Education Statistics Agency show that some ethnicities are still lagging behind when it comes to medicine. Students of Black Caribbean origin, like myself, are not well represented at medical school in comparison to White students or indeed those from certain Asian backgrounds. These disparities are also seen among qualified doctors.

When it comes to social background, the data shows that only a small proportion of students from less privileged backgrounds study medicine. For instance, a study of 22 UK medical schools during 2009-2012 highlighted that most people studying medicine come from the most affluent areas. Students from less privileged backgrounds are less likely to apply to study medicine and also less likely to gain a place. Even though only 7% of all students go to independent schools,this group makes up over a fifth (22%) of the medical and dentistry cohort at university.

Yet, in an era where we are seeing a crisis in recruitment to general practice, it turns out students from privately educated backgrounds are less likely to become GPs than those who go to state schools. Perhaps it requires a wider experience of communities and an ability to relate to people from a range of backgrounds to yourself.

The reasons for these patterns are likely complex and multifactorial; from a lack of confidence or self-belief, to a lack of financial investment from the Government and support from schools. I remember how difficult it was for me to apply to medical school because I was not well connected to doctors, or students at university. I studied at a comprehensive school that was less well equipped to help me with the medical school application process in the way I now understand private and independent schools help their students.

To bring about change we need to empower students – they need to see that others have ‘made it’ so they know their dreams can become a reality. At all levels and across institutions we need to ensure the future generation are supported and guided to choose their path carefully, which may be a career in general practice.

Last year, during my year out of training, I decided to help tackle this issue by launching the company DreamSmartTutors. Through this, as well as separate voluntary work, I go out into schools and local communities, showing young people from a wide variety of backgrounds that a career in medicine is achievable despite their circumstances.

As a profession we need to do more to engage with the younger generation. For instance, making work experience more accessible whether that is in a general practice or a hospital setting. The Government needs to invest more in students who are not well connected to professionals so that we can uncover the talented individuals who are currently being overlooked day by day.

Dr Patrice Baptiste is a GPST2 in London and founder of DreamSmartTutors

 

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Readers' comments (16)

  • Azeem Majeed

    Thank you for your article Patrice. At Imperial College London, we have established a programme to encourage children from deprived backgrounds to apply to careers in the health professions.
    https://goo.gl/F4pMRe

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  • Monty | GP Partner/Principal11 Aug 2017 11:57am

    ... as opposed to work?...rather sinister monty?

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  • The reason behind this is its well known to be easier to achieve 3 A s when there are only 5-10 people in your study group - plus the cost of tutoring private school children are more likely to afford.
    Also people from private school can afford to take a year or two out of work and have connections to easily change career so they are dropping out because they can afford to.
    The background of medical students should be more reflective of the community they work in .

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  • The article does rather stereotype doctors as generally "white, privately educated toffs" but in reality this is fiction... this already started to change quite a long time ago (which is a good thing). You did well...well done.
    However, I went to a state comprehensive where kids sniffed light fuel and teachers did not even mark your homework. I was not "well connected" and knew nobody of any influence. Now, you might meet me and assume that I am one of these "toffs" so I'd suggest it's best not to make any assumptions about other people or their backgrounds as this can dilute their hard work or achievements in life (if it is assumed they had it "easy").

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  • Affirmative action is the new fascism...read Thomas Sowell on the disasters of this policy in African Americans.

    So....poor kid gets to med school...qualifies and after 10years is rich (compared to his background) . ..and 2o yr on his/her kids are rich kids. My point? Education is free. Med study is long and hard. Opportunity cost is also very high.

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  • Vinci Ho

    There are multiple interesting issues here:
    (1) Students from affluent families are more likely to enter medical school.
    (2) These medical students from more advantaged backgrounds are less likely to become GPs.
    (3)Private schools are doing better than independent schools as far as medical school entrances are concerned.
    (4)There are relatively less representation of ethnic minorities in medical schools and hence , medical professions.
    xxxxxxxxxxxxxx

    I am not attempting to find the explanations for these 'phenomena'. All I would say ,instead ,is the degree of extremity in each phenomenon reflects the kind of society we live in and the type of governing hierarchy.
    The conflicts involving social classes , ethnic origins and religious beliefs have never stopped in human history. The notions of 'some types are better than the others' and 'we want to stick with the same type' continue to haunt our consciousness deep down . It is perhaps a naturally occurring temptation to use these arguments, if they apply, whenever there are disputes and differences in our societies: rich against poor(e.g.capitalism Vs socialism), racial conflicts(e.g. whites against blacks) and religious tribalism (e.g. Christianity Vs Islam) . The list can go on with further breakdown in term of differential polarisations. Even George Orwell was suspected for his intentions when he wrote the prose 'Antisemitism in Britain in 1945 .( read it for your own judgement).
    We let the disputes and differences ferment into divisions and prejudices . With the catalysts of arrogance and bigotry, we took adversarial actions against each other .
    May be , we have more liberties in 21st century with the advent of IT technology and globalisation but inequality is never a question being answered properly.In fact , liberty had often taken inequality for granted .
    It is saddening yesterday to see a quick revision of the American Civil War when white nationalists confronted viciously with counter-protesters as the statute of one Confederate general was to be removed in Virginia.This took place in the country with largest world economy led by a president who only favours Twitter as the mean to convey his arrogant and belligerent comments to his people . Locked and loaded , he is now 'ready'(at least , verbally) for a war against another Mad King in North Korea

    Mencius said ,''those malevolent with no virtues occupying high positions in a hierarchy spread the evil through the most.''

    Evil Mao also once said , ''there is no love coming from no reason and there is no hatred coming from no origin.''

    xxxxxxxxxxxxx

    What could be done better ? We still turned to our political leaders . In fact , we elected them to represent and 'educate' us so as to find the way forward . In critical times in history, we need leaders with visions to create a relatively harmonious environment. The task of preventing extreme ideologies to creep into the mainstream is paramount.
    Yes , it is easy said than done when you have a ,what appears to be, 'dire' reality. But in times, our expectation (in my opinion) could have been met by some humility and honesty from these elites we had chosen. Unfortunately, the old mistake of succumbing to self and partisan interest overruled the quest of social justice . It was a rarity to see a US veteran Republican senator to vote for his principles but against majority of his party in a repeal healthcare bill(though contentious in nature) established by the previous president of the opposition party, shortly recovering from his major operation to remove a nasty brain tumour.

    Before he became prime minister in 1940 , Winston Churchill was alone with very little support from Tory party led by his predecessor for his stance against appeasement policy on Hitler. His principles triumphed eventually but was not with sacrifices.
    xxxxxxxxxxxxx
    Despite how much we complained of the adversities we are experiencing in our medical profession(s) , our young generations continue to show great passion and enthusiasm for medical school training. Most of my daughter's classmates want to do medicine as long as their grades will allow(she made up her mind to do environmental science long before). Why?
    Doctors are the most trusted by public . This has become a common knowledge, poll after poll; study after study. If one fails to recognise the humility and honesty from our politicians, doctors can be the sanctuary to provide the trust he or she is yearning. Generically, we have halo on top of our heads. The mission of 'saving lives' is supported by medical science but we all know it is always about treating the whole person. Medicine is an art , not a science. The popular culture might have a parochial view that specialist doctors like cardiac and neurosurgeons matter a lot more . To some extent , it is an appeal to our youngster from elite families . No disrespect, the truth is family doctors are treating patients with multiple characters from different backgrounds everyday in the frontline.General practice is even more artistic as we look after collectively the physical, mental and social well beings of these patients and their families we know well .Something people tend to forget so easily . A consultant colleague told me a few years ago ,'' I cannot do your job , it is so hard to do your job well these days.''
    Frankly ,the way general practitioners being treated by this government is disrespectful. But that just demonstrates one of its failures to address the best interests of people in the country, especially those just about managing (JAMs) famously highlighted by our JAM prime minister .
    xxxxxxxxxxxxxxx
    If the arguments mentioned in this article are correct , the government should be targeting at more non-affluent students(less likely to enter medical school) as they are more likely to become GPs . It has an ambition of 5000 more GPs by 2020 to fulfil. What you educate and train today are the ones who will potentially maintain the pillars in 20 years time. Rendering them debt stricken on leaving 5 years medical school is certainly counterproductive and nonsensical.
    As I said many times , we did not start this war in the beginning but it is now prudent for those key opinion leaders (KOLs) representing us to fight at all corners against this government to secure better terms and conditions for this profession and its forthcoming generations .

    There were certainly other better times to be a GP.
    But at no other time in history,choosing to become GP is more admirable and respectable..........

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  • Vinci Ho

    Correction
    In fact , liberty had often taken eqiality for granted .

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  • I don't think lack of diversity is the main issue. As you acknowledge, Asian doctors have flourished in the NHS, and at the risk of (positive) stereotyping they have frequently propped up primary care during its many crises through sheer hard work. Many Asian GPs I know work full time yet still cover OOH shifts, something many of my fellow Caucasian colleagues abandoned years ago.
    What we really need is an influx of people prepared to graft. The shift towards part time portfolio careers has exacerbated the current crisis, and the slow suffocation of partnerships has undermined the concept "ownership" of workload.
    It's too simplistic to simply say we need more poor or black or male GPs, what. we really require are people prepared to put in the hours, irrespective of socio-economic background.

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  • "...it turns out students from privately educated backgrounds are less likely to become GPs than those who go to state schools. Perhaps it requires a wider experience of communities and an ability to relate to people from a range of backgrounds to yourself."

    Dear oh dear.

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