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Disadvantaged students with lower grades perform just as well in medical degrees

Study comes as Oxford University has been forced to defend the under-representation of black students and those from less well off areas

Alex Matthews-King
Health Correspondent
Thursday 24 May 2018 08:29 BST
Pupils from worst schools outperform privately educated peers with the same A-levels
Pupils from worst schools outperform privately educated peers with the same A-levels (Getty)

Disadvantaged students from the worst performing schools do just as well or better in medical degrees as students from top schools, even when their A-level results are worse, a major study has found.

These pupils actually outperformed their privately educated peers with the same grades and the researchers, led by the University of York, are say competitive medical school entry requirements should be lowered for applicants from a school with low average A-level results.

Considering the “context” pupils were educated in could also help to address diversity issues in medicine and doctor shortages, which are particularly acute in the most disadvantaged regions.

Currently half of medical degree entrants are privately educated, despite just five per cent of students in the UK going to private schools, and black and minority ethnic doctors are seriously under-represented in some specialities.

“This study suggests that relaxing A-level grade entry requirements for students from the worst performing secondary schools is beneficial,” said Lazaro Mwandigha, from York’s Department of Health Sciences.

These students are “just as able to keep up with the pace of a medical degree”, he added.

The report comes as a diversity row embroils Oxford University where some colleges accepted just a handful of black students and just 11 per cent of entrants were from a disadvantaged background – though this is up from seven per cent in 2013.

Labour MP David Lammy told the BBC’s Today programme: “The truth is that Oxford is still a bastion of white middle-class southern privilege. They have to explain why you are twice as likely to get in if you are white as if you are black and why you are more likely to get in if you are from the South than the North of England when you apply."

While the university accepted the criticism it said a part of the problem was down to a “very large pool” of white applicants with three As or more at A-level , and a very small number of black students with these grades.

But the study, published in the BMJ Open journal, suggests that only focusing on top grades means the best future doctors may be missed.

The team were able to link school and university data for 2,107 students enrolled in 2008 at 18 medical schools, and compared the university selection criteria with medical school admissions test and exam results over the five year course.

“Entrants from the most poorly performing schools have achieved A-level outcomes ‘worth’ one to two grades more than those from the top performing schools, in terms of their ability to predict undergraduate achievement,” the study said.

It added that students from selective, academically high-performing schools “are grossly over-represented at medical school” and paradoxically perform worse.

Some medical schools have already begun a process where they offer “discounted” grade offers to pupils form disadvantaged schools and may have serendipitously improved their institutions’ performance.

“This study is the first robust evidence that grade discounting for pupils from underperforming schools is justified,” said the study’s supervisor Dr Paul Tiffin.

Mita Dhullipala, co-chair of the British Medical Association’s medical students committee, said it was good to see more research backing inclusive entry requirements, especially when many areas are “struggling to recruit and retain staff”.

She added: “This study shows why efforts to improve access to medical education are so important.

“We know students from certain areas of the country and from less affluent backgrounds are severely under -represented in medicine, but here we have evidence that once at university, they perform as well as, if not better than their peers.”

Clare Owen, assistant director of the Medical Schools Council, said: “The Medical Schools Council recognises the benefits of admissions which take applicants’ backgrounds into account and this year published a guide which collects together the best practice of medical schools as they implement contextual admissions.

“Each medical school must decide on the best approach for its circumstances and this research will help them by making a significant contribution to the evidence base”

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