Why do we need UKMACS?

The lack of doctors poses a major risk to patient care

The National Health Service (NHS) is critically short of doctors, especially in general practice (GP) and in certain geographical areas. This means patients have unequal access to care. To have a sustainable UK medical workforce we need medical schools to select and educate more GPs, and for medical schools to select more doctors who are able and willing to work in under-served areas of the country.

In 2016 the Government announced there would be an extra 1,500 English medical school places. There are likely to go to medical schools that produce more GPs, and that select and train doctors from ‘non-traditional backgrounds’ (i.e. from social groups currently underrepresented in medicine), who – it is assumed – will be better at caring for under-served populations. A major problem with this solution is the poor evidence base for how medical schools should achieve it.

Medical schools attract and produce different types of doctors, but we don’t know why

Some medical schools produce more GPs than others, and some attract and accept more applicants from non-traditional backgrounds than others. It is unclear why. There is a tension between the desire to provide doctors who are more representative of the patient population, and maintaining high academic standards. Doctors from minority ethnic backgrounds and lower socioeconomic groups can struggle academically but it is uncertain how much this is because of their experiences before medical school, and how much it is due to their experiences during medical training. It is also uncertain how much a doctor’s performance in exams relates to the care they give patients.

An understanding of medical applicant choices is crucial to address workforce problems

Most medical selection research examines the selection tests  medical schools use to choose students. But to address the problems in the medical workforce, we also need to understand how different types of applicants choose different types of medical schools because – as one medical school admissions dean put it – “we can only select from those who apply”. Long term follow-up of medical students is also necessary to understand how applicant factors predict doctor outcomes.

Read more about the research methods UKMACS will use to understand and address these issues.