Are efforts to attract graduate applicants to UK medical schools effective in increasing the participation of under-represented socioeconomic groups? A national cohort study

Introduction
Attracting graduates was recommended as a means of diversifying the UK medical student population. Graduates now make up nearly a quarter of the total medical student population. Research to date has focused on comparing the socio-demographic characteristics of applicants to and/or students on traditional and graduate entry programmes (GEMs), yet GEMs account for only
40% of the graduate medical student population. Thus, we aimed to compare the sociodemographic characteristic and outcomes of graduates and non-graduate applicants across a range of programmes.
Methods
This was an observational study of 117214 applicants to medicine who took the UKCAT from 2006 to 2014, and who applied to medical school through UCAS. We included applicant demographics, UKCAT total score and offers in our analysis. Applicants were assigned as graduates or nongraduates on the basis of their highest qualification. Multiple logistic regression was used to predict
the odds of receiving an offer, after adjusting for confounders.
Results
Irrespective of graduate or non-graduate status, most applicants were from the highest socioeconomic groups and were from a white ethnic background. Receiving an offer was related to gender and ethnicity in both graduates and non-graduates. After adjusting for UKCAT score, the odds ratio of an offer for graduates vs. non-graduates was approximately 0.5 (OR=0.48, 95% CI 0.46-
0.49).
Discussion
Our findings indicate that the aim of diversifying the medical student population on socio-economic grounds by attracting graduates has been only marginally successful. Graduate applicants from widening access backgrounds are less likely than others to be offered a place at medical school. Different approaches must be considered if medicine is to attract and select more socially diverse
applicants.