Featuring an interview with UCL’s Target Medicine

Written By Rujuta Kulkarni

Who gets to study Medicine? This question is assumed to have a straightforward answer:   that the most capable and hardworking applicants are the ones who get in. But the reality is more complicated. Each year, tens of thousands of applicants compete for a limited number of places, with only one in ten securing an offer. In such a high-pressure environment, even small advantages can make a difference. This is where privilege in medicine comes in - the unspoken socioeconomic and cultural advantages that influence who gets to apply and ultimately succeed. Students from disadvantaged backgrounds are less likely to apply to medicine and are less likely to be accepted when they do¹, revealing that who gets to study medicine is not determined solely by hard work or ability, but also by access. Recognising this is an important step towards improving fairness and inclusivity across medicine.

At UCL, Target Medicine, a student-led widening participation initiative, works to bridge this gap by supporting students from underrepresented backgrounds throughout the medical school application process. I had an engaging discussion with one of the programme’s team leaders, Amman, who has volunteered with Target Medicine since his first year. He spoke with so much passion and honesty, offering invaluable insights into the barriers students from underrepresented backgrounds face in accessing medicine. I learnt more about the incredible role Target Medicine plays in building the confidence of these students and preparing them for the medical school application journey. Target Medicine pairs Year 12 pupils with medical students, who they meet over a series of face-to-face structured sessions on personal statement writing workshops, UCAT preparation, work experience and more. The programme ensures that the mentees receive the guidance and support that every applicant should have access to. 

“It shows you how much these students deserve to be in medicine,” Amman said, reflecting on the personal statement writing workshops. “It also reminds you why you’re in medicine yourself.”

In 2021, 75% of UK medical school entrants came from higher socio-economic backgrounds, while just 5% were from the lowest socioeconomic group.² Socioeconomic status, which can have a significant impact on access to medical school. Often, the impact is subtle, starting by shaping an individual's confidence and expectations of medicine, which influences the application process even before it begins. Research suggests that pupils from disadvantaged backgrounds view medicine as an “elite” career and generally underestimate their chances of a successful application. Many of these students had a vague understanding of what a medical career involved and limited opportunities to gain insights³. UK medical schools encourage applicants to do work experience as a way of exploring the realities of medicine, but is this as easy as it sounds? 

A study on general practice work experience found that participants who attended comprehensive schools were less likely to secure placements than those from private or grammar schools.⁴ One reason for this may be disparities in resources between schools. State schools may lack the funding or dedicated staff (such as career guidance advisors) who can help students find work experience placements; whereas, better-resourced schools can provide this structured support. Geography also plays a role, as areas with fewer healthcare settings simply offer fewer work experience opportunities. Without relevant work experience, applicants can feel as though they are already falling behind in the competition. 

Target medicine sees this first-hand. When asked about the biggest challenges the mentees face, Amman didn’t hesitate to say “finding work experience”. Many students aren’t sure how to even begin finding placements. It is undoubtedly a hassle for everyone, but it can be a more daunting task when you don’t have those connections to medical professionals. Amman described how Target Medicine teaches students to write emails professionally, advising them on who to reach out to, thereby building their confidence in reaching out to doctors for work experience and teaching them how to reflect on their work experience. For many students, this is the first time anyone has guided them through the process. 

Generally, students from lower socioeconomic backgrounds face barriers due to a lack of guidance and information. In 2021, 74% of entrants had at least one degree-educated parent ². Coming from a family background that has experience with higher education provides applicants with better “navigational capacity” - better understanding and ability to access the pathways, resources and “hidden” expectations for a successful application. Amman recalled a student who was unaware of the early UCAS application deadline for medicine and so had to complete their personal statement in under a month. 

There is also the advantage of “insider knowledge” - access to informal networks of medical students and doctors. While rarely spoken about directly, insider knowledge has a part in shaping who feels more prepared for the application process. Knowing medical students or doctors can make the process feel clearer and less overwhelming. Having someone to review your personal statement, guiding you through reflective writing, and practising interview questions with you may give you a competitive edge. 

Students from ethnic minority backgrounds, particularly those who also come from lower socioeconomic groups, often experience layered barriers, including stereotypes, lower expectations from teachers, and fewer role models within medicine, which may reinforce the idea that they “don’t fit the mould” of a typical medical applicant. Programmes like Target Medicine actively play a role in countering this. Seeing medical student mentors who share similar backgrounds can transform how mentees see themselves and their future. 

Academic achievement represents another hurdle. High GCSE and A-level grades are the foundation of medical school entry, yet access to these outcomes is far from equal. In 2023, this was reflected by the record north-south gap in GCSE grades, with pupils in London far more likely to achieve top GCSE grades than those in the north-east. These disparities often stem from the educational environment the students are exposed to: those from lower socioeconomic backgrounds are more likely to attend schools with fewer resources, larger class sizes and thus limited support. Meanwhile, students at better-funded schools often benefit from more focused teaching, academic enrichment and extracurricular support. These students may also have access to private tutoring, which can provide tailored support and help boost grades, but remains financially out of reach for many others.  

UCL and The Sutton Trust found that pupils from the most socio-economically disadvantaged backgrounds had a UCAT score of nearly 5% less than the least disadvantaged.² The UCAT, the entrance exam,  while intended to address disparities in offer attainment between applicants, is instead becoming another barrier. Although the UCAT Bursary Scheme exists to cover the cost of the exam, it doesn’t cover the cost of UCAT preparation. Many students feel pressure to purchase paid UCAT question banks, preparation courses, and more practice materials to get a competitive edge. Those unable to afford these resources may feel like they will struggle to reach competitive scores. 

Unfortunately, the costs do not stop there. On top of UCAT preparation, students may also use expensive resources for MMI interview preparation, from paid MMI mock exam practice to tutoring, which is not accessible to all students, creating inequity among applicants. Then there’s the flashy “summer schools” run by many medical school application companies that offer work experience and support with applications in exchange for a couple grand. Aside from costs associated with the preparation, travel and accommodation can also be a barrier. Students can be deterred from applying to certain medical schools because they cannot afford the travel costs to and from their home or the higher cost of living in these universities' cities, especially London. In this way, financial pressures also influence where applicants feel they can apply in the first place. 

UCL has one of the largest Widening Participation operations in the country,⁵ including Target Medicine. However, there’s always more we could do. When I asked how the medical community could be doing more, Amman emphasised that widening participation shouldn’t end once students secure a place. “We work hard to get them in,” he said, “but we don’t always help them once they’re here. These students may need extra support, but we’re not giving them enough.”  Ensuring meaningful ongoing support throughout medical school is a key step to levelling the playing field. He also highlighted that Target Medicine’s reach is limited mainly to London, leaving out talented students elsewhere in the country who face even fewer opportunities. So, expanding the outreach of Target Medicine beyond London would be extremely beneficial. 

Addressing inequality in medical admissions starts with recognising that not all applicants begin from the same place. While dedication and intelligence matter, there are nuances to the application process that pose hurdles to many. Programmes like Target Medicine show the power of supporting, guiding and providing representation in helping students realise their potential. True widening participation means ensuring that the doctors of tomorrow reflect the communities they serve, and that talented students are not held back by barriers they have no control over.

Why have I written this article? (if you’re curious) 

Personally, I don’t meet the criteria for a widening participation application, but I still found the application process more difficult than many of my peers. I had no UK connections to help secure a work experience placement, and ultimately obtained it through a distant relative after a while. I also found the process more expensive than I expected, so I tried to touch on the topic of the hidden costs of the application.  This got me thinking about how much harder the process can be for someone facing many more barriers. That’s what led me to explore the nuances of medical admissions and to do an interview with Amman in Target Medicine (who is also in RUMS Review and wrote an amazing article on Target Medicine, so go check that out too if you haven’t already).

Read the rest of the edition here