Why do medical students choose St Mary's Hospital Medical School?

'I'd have to fight for my life there': a multicentre qualitative interview study of how socioeconomic background influences medical school choice

Students from lower socio-economic backgrounds who were educated in state funded schools are underrepresented in medicine in the UK. Widening access to medical students from these backgrounds has become a key political and research priority. It is known that medical schools vary in the number of applicants attracted and accepted from non-traditional backgrounds but the reasons for this are poorly understood. This study aims to explore what applicants value when choosing medical schools to apply to and how this relates to their socioeconomic background. We conducted a multicentre qualitative interview study, purposively sampling applicants and recent entrants based on socioeconomic background, stage of application and medical school of application. We recruited participants from eight UK medical schools. Participants attended semi-structured interviews. We performed a framework analysis, identifying codes inductively from the data. Sixty-six individuals participated: 35 applicants and 31 first year medical students. Seven main themes were identified; course style, proximity to home, prestige, medical school culture, geographical area, university resources, and fitting in. These were prioritised differently depending on participants' background. Participants from lower socioeconomic backgrounds described proximity to home as a higher priority. This was typically as they intended to be living at home for at least part of the course. Those from higher socioeconomic backgrounds were more concerned with the perceived prestige of medical schools. Since medicine is a highly selective course, only offered at a minority of UK higher education institutions, these differences in priorities may help explain observed differential patterns of medical school applications and success rates by applicant social background.

Students' approaches to medical school choice: relationship with students' characteristics and motivation

OBJECTIVES

The aim was to examine main reasons for students' medical school choice and their relationship with students' characteristics and motivation during the students' medical study.

METHODS

In this multisite cross-sectional study, all Year-1 and Year-4 students who had participated in a selection procedure in one of the three Dutch medical schools included in the study were invited to complete an online survey comprising personal data, their main reason for medical school choice and standard, validated questionnaires to measure their strength of motivation (Strength of Motivation for Medical School-Revised) and autonomous and controlled type of motivation (Academic Self-regulation Questionnaire). Four hundred seventy-eight students participated. We performed frequency analyses on the reasons for medical school choice and regression analyses and ANCOVAs to study their associations with students' characteristics and motivation during their medical study.

RESULTS

Students indicated 'city' (Year-1: 24.7%, n=75 and Year-4: 36.0%, n=52) and 'selection procedure' (Year-1: 56.9%, n=173 and Year-4: 46.9%, n=68) as the main reasons for their medical school choice. The main reasons were associated with gender, age, being a first-generation university student, ethnic background and medical school, and no significant associations were found between the main reasons and the strength and type of motivation during the students' medical study.

CONCLUSIONS

Most students had based their medical school choice on the selection procedure. If medical schools desire to achieve a good student-curriculum fit and attract a diverse student population aligning the selection procedure with the curriculum and taking into account various students' different approaches is important.

A qualitative study of medical school choice in the UK

BACKGROUND

Examining the factors that make a medical school attractive (or otherwise) to potential students is particularly important but there is little empirical evidence that explores this issue.

METHODS

Semi-structured interviews were undertaken with 24 prospective medical students at six schools and colleges in England. The interviews aimed to elicit detailed information on the why and how of medical school choice, in students' application and acceptance decisions.

RESULTS

Three categories of medical school attributes stood out as positive determinants of choice: academic factors (with reputation considered the most important), location factors (specifically preferences for particular cities) and intangibles (gut feelings and personal contacts and recommendations). Most of students' decision-making activity was undertaken during the admissions stage of the application process.

CONCLUSIONS

The results are important in explaining why the students in the sample did not rate the new medical schools highly and also suggest that few of the important attributes can be manipulated by the schools themselves.