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Last Updated: Saturday, 29 March, 2003, 02:13 GMT
Is there a doctor in your house?
By Mike Baker
BBC education correspondent

Mike Baker
He was inspired as a boy by James Robertson Justice playing Sir Lancelot Spratt in the film Doctor In the House.

Now, as a pin-striped member of the Council of the Royal College of Surgeons, with a hearty manner to match his mentor, he might not appear the most likely champion of widening access to university medical school.

But consultant surgeon Andrew Raftery is doing something which other universities may want to copy if they are serious about broadening the social background of their students.

With the government about to publish its plans for the new universities "access regulator", admissions tutors are looking for ideas.

They need schemes to attract students from a wider range of social and educational backgrounds.


But these must not lay them open to accusations of bias against middle-class students from good schools.

When he is not dispensing advice on the wards of Sheffield hospitals, Andrew Raftery fulfils his other role as sub-dean for admissions at the medical school of Sheffield University.

This is where he started a pioneering scheme to encourage children from social groups under-represented in higher education to study medicine and become doctors.

The Sheffield Outreach and Access to Medicine Scheme (Soams) is unusual because it starts, not with sixth-formers, but by targeting school pupils as young as 13 at secondary school.

Its starting point was an attempt to change the stereotype of the sort of student expected to apply to Medical School in Britain.

According to Mr Raftery, these characteristics are: a young person who is predicted to get 3 A grades at A-level, has been a school prefect, is widely travelled, does worthy voluntary work, and plays the cello.

Jeeves and Wooster
Is the medical school student intake not broad enough?

Of the 2,700 applications for just 238 places to study medicine at Sheffield, Mr Raftery estimates almost half fit this stereotype.

Many will make good doctors. But Soams is looking for people from a wider range of less middle-class and privileged backgrounds.

In Mr Raftery's words, it is looking for young people who "through no fault of their own do not play the cello but who could make good doctors".

The aim of widening the intake is not simply motivated by university concerns about broadening participation.

It is also prompted by concerns that the medical profession has failed at times because its selection criteria, and entry, have been too narrow.

Mr Raftery quotes the Kennedy Report into the scandal of the treatment of children with heart problems at Bristol Royal Infirmary.

It criticised the openness and sensitivity of some medical staff and recommended: "Access to medical schools should be widened to include people from diverse academic and socio-economic backgrounds."

So how does Soams work? It starts by identifying schools in some of the poorer parts of South Yorkshire. Only schools with low examination scores and low staying-on rates are allowed onto the scheme.

Gory slides

The schools are then invited to nominate up to three pupils each in Year 9 who might have an aptitude and interest in studying medicine.

The pupils must be from families with no previous experience of university-level education. At this stage, the scheme offers 100 places.

Those selected are then given a gentle introduction to life as a doctor. This includes watching selected excerpts from TV hospital dramas (Raftery hopes ER, Casualty and Holby City will do for today's youngsters what Doctor In the House did for him), a bit of practice on plastic dolls and watching some "real gory slides".

The initial 100 are filtered down to 75 for the GCSE years, from age 14 to 16.

Doctors in ER
Doctors need to operate under severe pressure

The requirement for those staying with the scheme is that they must be doing the appropriate science subjects at GCSE and attend some work experience placements in local hospitals, as organised by the university.

The big "cut" comes at age 16, when the number on the scheme is reduced to 25.

At this point, there is a formal selection procedure for what amounts to a pre-entry programme. Four grade As at GCSE are a minimum requirement.

The sixth-formers get more medical work-related experience, go on summer schools, and receive advice on how to prepare for university interviews. Parents are closely involved throughout.

The students' aptitude and commitment to medicine are now thoroughly tested. There is a residential course at the university and various one-day schools.

They meet current undergraduate medical students and receive talks from practising doctors.

According to Andrew Raftery, this includes an illustrated talk from a plastic surgeon with "the most gory slides - we always carry two out from the back".

Selection not automatic

In short, the scheme provides the 25 students with every possible bit of help and guidance to boost their confidence and knowledge.

They can then compete with other applicants from better schools or from families with no experience of university education or professional medicine.

Twenty places at Sheffield's medical school are reserved for those on the scheme.

Those selected receive a bursary worth 1,000 a year for each of the five years of the course.

However, there is nothing automatic about their entry to the university. They must be successful at interview and must generally achieve an A and 2 Bs at A-level in appropriate subjects.

Special consideration may be given to Soams scheme students who just miss the A-level requirements.

Those who fail to get into the school of medicine are directed to other parts of the university or given guidance on entry to other medical careers, such as nursing or physiotherapy.

According to Andrew Raftery, the scheme is not designed "to take lame dogs but to bring on those with ability so they can compete on a level playing-field".

The first cohort on the scheme take their A Levels this summer. Their success at getting into university and going on to become successful doctors will be watched carefully.

The new access regulator should make it an early task to go and see how this scheme is working.

We welcome your comments at educationnews@bbc.co.uk although we cannot always answer individual e-mails.

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