Social Inclusion or Social Engineering? The Politics and Reality of Widening Access to Medicine in the UK

Although driven by policy and investment, the available data suggests that, to date, UK efforts to minimise the barriers into professions such as medicine have had mixed success. We explore the myriad social, individual and structural reasons why the resources invested in widening access (WA) activities have not significantly increased the representation of applicants from lower socio-economic groups within medical schools. We discuss the different discourses of widening access/increasing diversity in the UK context—notably those of ‘social mobility’ and ‘increasing diversity to improve workforce efficiency’—and how these are interpreted and enacted ‘on the ground’. This includes examining the synergies and tensions between widening access and maintaining quality, and the gap between political directives and policy enactment within medical schools. We discuss if the different discourses of widening access can be reconciled, and if so, whether this can be done in a way to support widening access.