Do medical students with a disability experience adverse educational outcomes on UK medical courses?

BACKGROUND

International data demonstrate that medical students with disabilities experience differential awarding. One cross-sectional study finds lower graduation rates and scores in written exams, with no impact on clinical exams. Disabled students graduated with lower decile scores. This quantitative, retrospective, longitudinal study explored the impact of disability on exam performance, course performance and course discontinuation.

METHOD

Anonymised data were obtained for 1743 students on a UK graduate medical programme from 2011 to present. Statistical tests, including t-tests and one-way ANOVA were conducted for main effects of demographic variables on exam results and categorical outcomes. Regression models established the effects of variables and sub-categories of variables on results and categorical outcomes.

RESULTS

Significant main effects of disability on exam scores were identified, as well as failure probability. Regressions showed significant differences in outcomes between different types of disability, with mental health conditions predicting course discontinuation. A significant amplifying effect was found for BAME students with disability.

CONCLUSION

Disability had a significant negative impact on all course outcomes, illustrating inequity in medical training and an area of focus for curriculum development. Intersectional data identified a key disadvantaged subgroup of medical students.

The experience of widening participation students in undergraduate medical education in the UK: A qualitative systematic review

Introduction: Most widening participation (WP) research is focused on medical school recruitment; there is a paucity of research examining whether the experience of medical school itself is an equal experience for both 'traditional' and WP students.Methods: This qualitative systematic review used the Joanna Briggs Institute (JBI) meta-aggregative approach to characterise the experience of undergraduate medical education in the UK from the perspective of WP students. Seven databases were searched, 27 studies were critically appraised, and 208 findings were grouped into 12 categories and four synthesised findings.Results: The majority of the research found relates to ethnic minority groups, with reports of other WP groups being less frequent. Whilst WP programmes attempt to alleviate disadvantages prior to entering university, our findings suggest that difficulties follow WP students into medical school. Unfamiliarity with higher education and lack of representation of WP staff in faculty can deter help-seeking behaviour and result in lack of trust. Furthermore, students from different backgrounds can find their identity conflicted upon entering medical school. Despite difficulties in establishing social networks with 'traditional' medical student peers, WP students form strong relationships with students from similar backgrounds.Conclusions: Ultimately, these students find that the uniqueness of their experience is a useful tool for communicating with diverse patients which they come across and are able to overcome adversity with the help of a supportive institution.